Navigating the DNP Project in the Clinical Environment

Early collaboration with the targeted healthcare organization to complete the DNP project is essential. The well-planned DNP project can achieve two important goals. Foremost, the evidence-based practice change will benefit patients by moving the best research to the bedside. Additionally, excellence in the completion of the DNP project communicates the need to employ doctorally prepared nurses in healthcare organizations. Each DNP graduate should view themselves as an ambassador of the value of the DNP in the workplace. The current confusion surrounding the DNP role and inconsistency in DNP program curricula has led some to question the benefit and need for the degree (Chase & Pruit, 2006). The practice doctorate capstone project is an excellent opportunity to counter that argument and to achieve real quality improvement and safety in the clinical area as these nurse leaders use their expertise to lead clinical practice change (Brown & Crabtree, 2013). In fact, some argue that the DNP scholarly project is the most recognizable and strongest attribute of a DNP program (Edwards, Coddington, Erler, & Kirkpatrick, 2018). Healthcare leaders and faculty have an important role in ensuring the success of DNP projects, and ultimately ascribing value to this degree.

DNP students report barriers including a lack of academic support from faculty, issues related to work-life balance, finances and lack of confidence as significant challenges in their pursuit of the DNP (Hlabse, Dowling, Lindell, Underwood, Gutin Barsman, 2016). Educators have expressed concerns about quality of DNP programs, finding appropriate practicum opportunities, and preceptors (Terhaar, Taylor & Sylvia, 2016). These complex projects require collaboration among students, faculty and healthcare leaders to mitigate these barriers and develop quality projects that are beneficial to the healthcare organization and patients. Working together, healthcare organization leaders, faculty and students can impact the quality of evidence-based- quality improvement (EB/QI) projects completed while helping students develop necessary skills needed for implementation success.

Healthcare organizations can fill a much-needed support role for DNP student projects through active participation in the educational process. Nurse leaders can communicate project needs to DNP students and offer to mentor students in clinical operations, leading interdisciplinary teams and influencing others toward sustainable practice change. Successful collaboration requires that healthcare leaders first develop personal competency in EBP and work to create an EB/QI culture within their organization.

There is wide variation in the process and approvals needed for clinical projects within healthcare organizations. Faculty must engage clinical partners early and be aware of the approval processes and timelines for projects. Understand if the facility requires Internal Review Board (IRB) approval, or other contracts related to data use and sharing (Kaplan & Brown, 2009). To facilitate communication with leaders in the healthcare organization, faculty and students should adopt the language of the clinical area where the proposed practice change will occur. Faculty must work with healthcare leaders to negotiate and clarify the roles and responsibilities of DNP students, faculty members, and key leaders in the healthcare organization related to specific projects. To respect the time of the proposal review team at the healthcare organization, faculty must ensure that student proposals have good quality before the student submits the proposal for consideration. Mentor students in professional etiquette in written and verbal form as they present their project to nurse leaders.

DNP students must plan early and assess the needs of the clinical area before planning projects. The needs assessment should include knowledge of the current practice in the organization and the organization's openness to consider change. Identify key stakeholders related to specific projects and include them in planning. Remember that the development of leadership skills and the ability to influence others is critical to the success of any proposed practice change.