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The Doctor of Nursing Practice: A Report On Progress
The Doctor of Nursing Practice: A Report On Progress
A Report on Progress
C. Fay Raines, PhD, RN
President
American Association of Colleges of Nursing
March 21, 2010
Creating the Future
The movement to the DNP is about producing the most
competent nursing clinicians possible to meet the nation’s
healthcare needs.
AACN has always advocated that education makes a
difference in clinical practice.
AACN members understand the mandate for change ‐ less
than 1% of nurses in the U.S. have doctoral preparation.
Raising educational expectations is common across
professions striving for excellence.
AACN Members Endorse the DNP
October 2004, strong majority vote to endorse the
Position Statement on the Practice Doctorate in
Nursing.
Members approved a target goal for transition of
APRN programs by 2015.
Position developed through dialogue with an array
of stakeholders and opportunities for comment.
Position identified the DNP as the appropriate degree
for advanced nursing practice.
Facilitating the Transition
Two AACN Task Forces created:
Task Force on the DNP Essentials
Task Force on the Roadmap to the DNP
April 2009, CCNE amended standards to require
DNP Essentials
CCNE evaluating and accrediting DNP programs
CCNE has accredited 18 DNP programs; 70
additional DNP programs are pursuing CCNE
accreditation
Organizational Responses
American Association of Nurse Anesthetists
Council on Accreditation will not accredit new master’s
programs for nurse anesthesia after 2015.
Mandate that all CRNA programs transition to the practice
doctorate by 2022.
All new CRNA grads must hold a practice doctorate by 2025 to
be eligible for certification.
The Nurse Practitioner Coalition Statement
7 NP organizations (AANP, ACNP, AFPNP, NCGNP, NONPF,
NPWH, NPNP): “the DNP degree more accurately reflects
current clinical competencies and includes preparation for the
changing healthcare system.”
Organizational Responses
National Organization of Nurse Practitioner Faculties
Endorsed the DNP and developed competencies for NP
practice at the doctoral level.
National Association of Clinical Nurse Specialists
Neutral position on the DNP; has developed DNP‐level
competencies for CNS graduates.
American College of Nurse‐Midwives
Recognizes the DNP as an option for some midwifery
programs.
Changes in CMS Reimbursement
AACN successfully advocated for CMS to change the
regulatory language regarding reimbursement for APRN
services from requiring nurses to hold a “master’s degree”
to holding a “graduate degree in nursing.”
This important language change removed any potential
barriers to DNP‐prepared nurses seeking reimbursement
for their services.
DNP Program Evolution
At the midway point to the 2015 goal, Schools of Nursing
have made great progress in transitioning to the DNP.
According to the 2009 AACN Annual Survey, 120 DNP
programs are currently enrolling students, with programs
now available in 36 states and the District of Columbia.
As expected, student enrollment in and graduations from
DNP programs has increased substantially over the last
five years.
DNP Enrollments & Graduations
6,000 Enrollments
Graduations
5,165
5,000
4,000 3,415
3,000
1,874
2,000
862
1,000 392 660
70 70 170 122 361
15
17 44 74
7
0
2002 2003 2004 2005 2006 2007 2008 2009
Programs: 2 2 3 11 20 53 92 119
Response: 100% 100% 100% 100% 100% 100% 100% 99.2%
Enrollments Increasing in Both
DNP & PhD Programs: 1997‐2009
6000
5000 Research
Focused
4000
3000
2000
DNP
1000
0
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Will employers want to hire DNP graduates versus
master’s prepared APRNs?
How can my school do this given state regulations?
Concern that we need clarity about grandfathering
current MSN‐prepared APRNs. (This concern was also
raised when NP education moved from the certificate to
the master’s level preparation.)
Strategic Planning – January 2010
Purpose:
To assess the progress toward the DNP
To identify next steps to address identified challenges
Reviewed multiple sources of information:
Current data on # of DNP programs, enrollment, and
graduations
Positions taken by other nursing organizations
Feedback from the Master’s Essentials Regional
Meetings
Market response to the DNP from employers and
students
Feedback from members
Strategic Planning – January 2010
Based on the strong response to the DNP from AACN
members and stakeholders, the Board reaffirmed its support
for the member position on the DNP and the 2015 goal.
Board recognizes challenges to this transition must be
addressed.
Will commit resources to develop tools, best practice
resources, templates.
Will facilitate consultation to schools seeking advice and
exemplars.
Will advocate for the DNP with policy makers and
certifying bodies.
DNP Data Collection
The Board asked for additional data from schools with
APRN programs in relation to the DNP to better assess
transition plans and identify support needed by schools.
AACN conducted three surveys in February and March 2010
targeted to schools in the following categories:
Schools with APRN programs and no previously expressed plans to
start a DNP program
Schools with APRN focused DNP programs, but no post‐
baccalaureate entry options
Schools with APRN programs that are planning a DNP program
Survey Results
When combined with AACN’s 2009 annual survey
data, the following results were found:
72% of schools with APRN programs (388 schools)
are either offering (120) or planning (161) a DNP
program.
62% of schools either offering or planning a DNP
program (281) are planning to offer a post‐
baccalaureate entry option.
Survey Results
The surveys asked schools to identify their greatest
challenges to opening a DNP program. Responses
included:
Insufficient faculty
Limited financial resources
State regulations
Lack of faculty support
When asked why some schools were NOT closing their
post‐master’s APRN programs, responders cited:
Strong interest from students in post‐MSN option
Regulatory requirements
Concerns about a possible drop in enrollments
Faculty reluctance
Survey Results
In all three supplemental surveys, AACN asked what
resources were needed by schools looking to transition.
Among the resources mentioned were:
Program development guidance; sample curriculum
Examples of capstone projects
Advocacy support at the state level
Faculty development
Partnership models
Referrals to consultants
Advice on managing costs and maintaining enrollments
Planning and program evaluation tools
Next Steps
AACN will work to address the needs identified through
the surveys.
Two Webinars planned this spring with DNP leaders to
provide expert insights and solutions to schools in
transition.
Will identify consultants and disseminate information on
best practices.
Will provide faculty development; highlight examples of
capstone projects and curriculum models.
Will work to develop models of collaborative/joint
degree programs.
AACN Resources for DNP Transition
While AACN works to develop new resources for
members, some tools are available:
DNP Roadmap Report
www.aacn.nche.edu/DNP/pdf/DNProadmapreport.pdf
DNP Tool Kit: Template for the Process of Developing
a DNP Program
www.aacn.nche.edu/DNP/toolkit.htm
DNP FAQs & Talking Points
Next Steps
AACN will seek best practices and advice from your insights
and experiences.
Schools are encouraged to leverage their influence with
policy makers, students, employers, and other stakeholders
to advocate for the DNP.
AACN will continue to identify challenges and address
issues of importance in our transition to the DNP.
This is about creating the
future for our patients and
our profession.