Many prominent organizations, including the American Association of Colleges of Nursing (AACN), the Institute of Medicine (IOM), the Tri-Council for Nursing, and the American Nurses Association (ANA), among others, agree: doctoral-prepared nurses remain a valuable commodity in the nursing profession.
For example, Susan B Hassmiller, Senior Adviser for Nursing with the Robert Wood Johnson Foundation, said that “strengthening the pipeline of nurses entering both research- and practice-focused doctoral programs is critical to meeting the nation’s growing demand for nurse scientists, faculty, expert clinicians, leaders and innovators.”
The American Association of Colleges of Nursing (AACN) cites a number of factors behind the push for more doctoral-prepared nurses in the U.S., including:
- The rapid expansion of knowledge within the nursing practice
- National concerns regarding patient safety and quality of care
- Shortages of nursing personnel
- The need for more nurses who can design and assess care and serve in leadership roles
- Shortages of nursing faculty, leaders in practice, and nurse researchers
The Doctor of Nursing Practice (DNP) is well-known for being the highest terminal practice focused nursing degree available, however, DNP programs are available with specialized tracks beyond advanced clinical roles that involve direct patient care. Many DNP programs are also available in various aggregate/systems/organizational focus areas designed to prepare nurses for influential positions both in and out of the clinical environment:
- Healthcare policy
- Public health
- Executive leadership
- Clinical education
Advancing to a Career in Organizational Leadership, Health Policy, Public Health, Informatics, or Clinical Education with a DNP
A Doctor of Nursing Practice (DNP) with a specialty track designated as one of the aggregate/systems/organizational focus areas (administration/executive leadership, healthcare policy, nursing informatics, or clinical education) is defined as a program that prepares nurses to work in influential positions that don’t involve direct patient care.
As administrators, healthcare policy specialists, informaticists, executive leaders and clinical educators, these DNP nurses would serve to:
- Clinical Educators – Prepare RNs and APRNs to serve as competent and confident clinicians
- Nurse Administrators and Executive Leaders – Serve in high-level administrative and executive leadership roles in healthcare organizations
- Nurse Informaticists – Manage and interpret healthcare data to identify trends, ensure patient safety and more
- Healthcare Policy Analyst – Work in government to analyze the efficacy and efficiency of current health policy and make recommendations for improvement
- Public Health Nurse – Design and direct public health policy to improve patient outcomes for individuals and populations
Nurses who pursue DNP programs with a clinical—yet non-direct patient care—focus go on to become transformational leaders who have the ability to impact healthcare delivery and health policy and improve the quality of outcomes for patients across healthcare systems and organizations.
A DNP program with an aggregate/systems/organizational focus in one of the above-named areas prepares graduates to:
- Utilize epidemiologic and other scientific findings to develop practice initiatives that improve the quality of care delivery
- Provide organizational and systems leadership to develop care delivery models
- Engage in clinical scholarship in an effort to evaluate the effectiveness of evidence-based efforts related to healthcare program delivery
- Utilize healthcare informatics and technology to improve patient safety and clinical outcomes
- Collaborate with healthcare professionals and other stakeholders to influence health policy and health promotion/disease prevention endeavors
What to Expect from DNP Programs with an Aggregate/Systems/Organizational Focus
DNP programs earn accreditation through either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Nursing Education (ACEN).
DNP programs in areas such as executive leadership, public policy, and administration prepare students to become change agents in healthcare policy and healthcare delivery systems.
DNP programs consist of about two years of full-time study and between 35-40 credits, including related clinical experiences and a final DNP project.
The core of a DNP program includes study in:
- Foundations of scholarship
- Foundations of grant writing
- Healthcare informatics
- National and global health policy
- Advanced statistics
- Methods for evidence-based practice in healthcare
- Quality improvement and patient safety
- Clinical program development, implementation, and evaluation
- Managerial epidemiology
Additional courses within a DNP program correlate to the chosen DNP specialty, such as:
- Adult learning
- Design of adult learning interventions
- Knowledge management in nursing
- Organizational concepts in nursing
- Creativity and innovation
- Healthcare finance for nurse leaders
- Social entrepreneurship
- The healthcare enterprise
- Clinical information systems
- Information technology project management
- Informatics project planning and development
The completion of a DNP requires at least 1,000 hours of supervised practice experience, 500 of which may be transferred from the student’s MSN program. Unlike DNP programs with an advanced practice nursing focus that must include clinical experiences related to direct patient care, DNP programs with an aggregate/systems/organizational focus allow students to focus their clinical hours on leadership activities, such as:
- Conducting assessments at a community practice
- Participating in committees
- Planning, implementing, and evaluating evidence-based practice projects
Final projects any comprise any number of activities, such as:
- Practice topic disseminations
- Systematic reviews
- Research utilization projects
- Manuscript submitted for publication
Admission into a DNP with a focus on executive leadership, nursing informatics, or clinical education, among others, requires a master’s degree—most often a Master of Science in Nursing (MSN). However, a number of institutions accept students with master’s degrees in similar fields, such as:
- Master of Business Administration (MBA)
- Master of Public Health (MPH)
- Master of Health Administration (MHA)
Candidates must also possess:
- Current and unencumbered RN license
- Resume or CV detailing their nursing experience related to the appropriate DNP focus
- Minimum GPA from master’s degree program
It is commonplace for institutions to require candidates to submit letters of recommendation from professionals knowledgeable about their academic and nursing leadership ability and a statement of professional goals.
Program Design/Delivery Options
In addition to campus-based DNP programs, online DNP programs are becoming increasingly popular, with many institutions now offering students the opportunity to complete some or all of their courses through online instruction. Students can then complete the clinical requirements of their program with the help of a faculty advisor/mentor and at a site close to home, often their place of employment.
Some online DNP programs require students to attend on-campus immersion experiences one or more times throughout the program. Immersion experiences provide valuable opportunities for students to meet faculty and interact with peers on a focused project.
Many institutions also allow students to complete their DNP program in a part-time or accelerated format. Accelerated formats feature a more rigorous curriculum that takes about 12 months to complete, while part-time formats feature a more relaxed curriculum that takes about 36 months to complete.
BSN-to-DNP Programs with an Aggregate/Systems/Organizational Focus for Bachelor’s Prepared Nurses
Many of today’s DNP programs offer two points of entry: one for the master’s prepared nurse (MSN-to-DNP) and one for the bachelor’s prepared nurse (BSN-to-DNP).
Nurses with a Bachelor of Science in Nursing may pursue their DNP through a BSN-DNP program (also referred to as a post-bachelor’s DNP), which includes the components of both the BSN and MSN combined to form one, streamlined program. Most BSN-DNP programs consist of about 36 months of full-time study (3-4 calendar years).
Provided they possess a current and unencumbered RN license, some BSN-DNP programs with an aggregate/systems/organizational focus allow candidates to possess a bachelor’s degree in a related field, such as business management or public health.
Students of BSN-DNP programs must first complete all necessary components of the MSN, including the completion of at least 500 clinical practice hours, before transitioning to the DNP.