Nursing is a profession that undergoes constant change. Advances in medical care, the development of improved patient care practices, the application of new technologies and the evolution of nursing education itself all contribute to a dynamic profession that not only responds to change but leads it.

This continuing evolution is especially true when it comes to the increasing importance of degrees like the Doctor of Nursing Practice.

"Right now, the profession is shifting in a way that, within the next few years, all nurse practitioners will be required to enter practice at the DNP level," says Michele Kilmer, assistant professor of nursing at the University of Arkansas. "MSN-level prepared nurse practitioner programs are not going to be recognized in the field in the next few years."

 

Michael Vinson, a May 2022 graduate of the Doctor of Nursing Practice program, describes his research project on May 13, the day before commencement, in a room filled with graduate nursing students and faculty at the Arkansas Union. The students created posters displaying their research project results and invited nursing faculty members to see and discuss their work.

 

These impending changes mean that it's a good time for BSN- and MSN-level nurses to start their progression to a DNP-level program that combines regular online coursework and clinical hours. In the University of Arkansas DNP degree track, students are required to design and execute a Doctor of Nursing Practice project as part of their degree program. These highly engaging four-semester projects are opportunities for students to utilize their expertise in the field of nursing and apply it for the benefit of the community and the profession.

The DNP Project: Going Beyond a Nursing Capstone

Many graduate education programs require capstone projects; traditional capstones ask students to apply the knowledge they have gained in a comprehensive way at the end of their degree programs.

DNP projects are similar, but they provide a richer, more immersive opportunity for nursing students to apply findings and breakthroughs they have learned to provide better health care to a wider range of people who may not have had access otherwise. And they help nursing professionals contribute to their profession in significant ways.

"I would tell any potential student, ‘If you want to be a nurse practitioner, you need to get a doctorate and complete your DNP project successfully,'" says Kilmer. "I would also tell current nurse practitioners who have not yet completed a DNP program that these projects build credibility to claim a seat at the table. The DNP degree gives students the tools and the confidence to enact policy change and propose new standards of practice. They equip you to be more than just a really great clinician; they prepare you to be a health care leader who can inspire change and lead confidently – which is what our field really needs."

So, what does a DNP project entail?

 

The DNP Project: Semester by Semester

Doctor of Nursing Practice projects are broken down into four semesters that occur in the final year of the DNP program. The first semester focuses on the planning phase of the DNP project, when students are asked to identify a gap in care that is resulting in poor health outcomes within their local health care system. The students then utilize knowledge of current evidence to propose a solution to the identified problem. Often, in this semester, students will begin to think about which health care facility they plan to include as their base of implementation.

The second semester is focused on proposal development and site agreement. During this semester, students further analyze the identified gap in care and finalize the proposals for their evidence-based solutions. This semester also requires students to organize final arrangements and permissions with the site where they intend to conduct their project.

The third semester centers on implementation when students put their proposed and finalized plans into practice. Throughout the semester, students analyze and adjust their projects as necessary to fine-tune the solution best suited to address the challenge and fill the gap in care.

While the DNP project ends in the fourth semester, ideally, the findings from the project extend beyond the degree program as DNP projects are designed to be a sustainable intervention for the site to continue without student assistance. The final step in the project process is dissemination, which involves sharing the results with various health care providers for an even larger reach of improvement through oral presentations, publications and other written formats.

Last spring, students created posters displaying their research project results and invited nursing faculty members to see and discuss their work. The event took place in a room in the Arkansas Union the day before commencement in May.

 

Choosing a DNP Project

The nursing school is committed to helping students choose a DNP project that will have an impact and that they can finish successfully. The faculty work with students to make this choice – what some may consider the most stressful part of the project – achievable and straightforward.

Students can select from five project areas: health policy, development evaluation, clinical inquiry, quality improvement and the translation of evidence into research. The faculty encourage students to think big and to not shy away from selecting a focus within one of these five options that will bridge a gap in care for the benefit of communities that have been traditionally underserved by the health care system.

Kilmer, who herself has lost family members as a result of gaps in care, says the program is committed to being community oriented. She and the rest of the faculty encourage students to explore ideas that would benefit low-income areas and regions with a lack of health care access.

"All of our research faculty focus on minorities, people of color and other historically marginalized groups that have circumstantial barriers to access," says Kilmer. "We teach our students to search for systemic changes to improve care in addition to the care they are providing to individual patients."

The projects are also chosen for the direct impact they can have on health care processes and patients. Kilmer goes on to mention that DNP students are working on projects ranging from reducing the preventable readmission rates of heart failure patients to improving educational and prevention plans for obesity to improving diabetes treatments for children and adults. Each of these projects entails developing solutions with the potential to make real-world differences.

"We want other hospitals, primary care clinics and other universities to use solutions that our students have developed and that are found to work over the course of their projects," says Kilmer. "This isn't just about a grade. In the end, a student's DNP project should be sustainable for progress in the field of nursing and allow that student to move forward as a qualified health care leader."

 

DNP Projects in Action

Kandace Williams, a graduate of the U of A DNP program, was completing her project during the height of COVID-19. Williams noticed a lack of communication between health care providers and family members of COVID patients. When her own mother contracted the virus, Williams was prevented from seeing her. The inability to speak with her mother and the barrier to information made the experience frightening for both Williams and her mother. It also spurred the development of her DNP project.

The experience inspired Williams to propose a new communication guide for health care workers. During her DNP project, Williams developed and implemented a guide that included information about the hospital, all the necessary phone numbers and addresses, information about what family members could expect regarding the virus and its progression and explanations regarding common equipment used to treat the symptoms of the virus. It also included a journal where families could write down their patient's information and keep track of questions they might have – this was especially useful at a time when most hospitals were so overwhelmed that families were only allowed to call once per day.

The implementation of Williams' project was so successful that the University of Texas Southwestern Medical Center in Dallas – where she was conducting her DNP project – adopted it as a standard care practice for its patients. Its use was also extended beyond just COVID-19 patients and their families. The dissemination of the project expanded to other hospitals that have also since adopted Williams' project.

"Another student wrote a protocol based on multiple evidence-based studies to improve osteoporosis in patients attending an infusion clinic," describes Kilmer. "That student was very successful as well. Every year I am surprised by what our students are able to accomplish in terms of making these important, incredibly helpful changes to care."

These kinds of sustainable, field-changing executions are exactly what the U of A hopes to inspire from its students during the DNP project phase of the degree program.

Why U of A's ONLINE Program?

The University of Arkansas DNP program faculty recognizes that most incoming students likely have full-time jobs. Some have families, dependents or other ongoing responsibilities. These adult learners are no stranger to "busy." The university knows that to succeed, DNP students need flexibility and a trusted partner in education who will help them reach their goals for their degree and careers.

The University of Arkansas DNP program is designed to be both flexible and achievable.

Each semester of the DNP program serves a unique purpose and each builds upon the last for real-world training and application. The program offers classes such as opioid education, rural health, disaster planning and disaster training – all of which serve in-demand, practical functions and make students valuable assets wherever their careers take them.

Though Kilmer warns that the DNP program at the University of Arkansas is not a go-at-your-own-pace online degree, she wants prospective students to understand the faculty are there to support each student along the way and have built partnerships with other departments at the university to provide helpful study resources and mentorship.

One partnership helps DNP students improve their written communication skills.

"Our department collaborates with the university's Writing Studio so that our students are able to write proficiently in the health care discipline, preparing them to communicate effectively as health care leaders," explains Kilmer.

Another partnership helps students improve their data skills.

"We also collaborate with the Educational Statistics and Research Methods department so that our students understand research methodology and statistical analysis," Kilmer says. "We purposely incorporated these collaborations to build a robust system geared for the success of our students."

She stresses that, with proper time management and utilizing the multitude of resources the university provides, DNP students can successfully plan and execute a DNP project.

Kilmer and the faculty of the DNP program share a commitment to the advancement of the field of nursing, and they want all of their DNP graduates to contribute to those advancements and to be part of the generation of nurses who will work to eliminate the lack of access and gaps in health care across the country.

"With the increasing complexity of health care, there are more opportunities that are becoming available for nurse practitioners, including full practice authority in many states," says Kilmer. "Our desire is to produce nurse practitioners who are compassionate clinicians and competent health care leaders."

To learn more about the DNP degree, visit the Doctor of Nursing Practice program page on our website .

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