The Role of the DNP Scholar in Preparing for Change

The Role of the DNP Practice Scholar: Preparing for Change

The Role of the DNP Scholar in Preparing for Change
What do you see as a positive aspect of the growing number of doctorally prepared nurses in nursing? How have you explained this new phenomenon of so many nurses with the terminal degree?

Preparing for Change

Let us not forget that our profession, nursing, is a new profession. Utilizing the vision of nursing leaders, the profession began producing nursing knowledge and essentially gaining recognition as a discipline in the past 50 years. The nursing leaders who emerged about the time World War II ended put great focus into clear curricula expectations. Subsequently, there began a focus on the development of nursing knowledge, the ways of knowing, and the generation of nursing science. The development of conceptual models, grand theory, middle range theory, and use of borrowed theory abounded as scholars tested theory through nursing research. There is a large volume of knowledge but it remains in the journals, not at the bedside.
Overcoming the Theory-Practice Gap

It has been written that nursing science drives transformation of practice (Parse, 1999). To this end, the need for assimilation of the scientific underpinnings of the DNP role cannot be understated (Chism, 2016; Dahnke & Dreher, 2010; Zaccagnini & White, 2017). The need to implement EBP now, today, accelerates not only from within but from the public as well. The Institute of Medicine (IOM) report challenges healthcare workers to have a clear education in patient-centered care, quality improvement, interprofessional collaborative practice, health information technology, and emphasizing EBP (2003). It is recognized that the issues involved in moving theory to practice are complex. There is a clear differentiation of nursing research, quality improvement, and evidence-based practice, with EBP as the key to moving science to improve clinical settings. The process of linking research to the clinical setting is best done by utilizing the framework of EBP (Dang & Dearholt, 2018). Our challenge is to perfect our ability to search and appraise this evidence. The DNP degree is designed to prepare specialized nurses who will function at the most advanced level of nursing practice—including using EBP. Your role is pivotal in moving EBP forward. The longstanding gap between theory and practice clearly shows the critical job DNPs have before us to bring evidence into the practice setting.
Driving Quality in Practice

We only need to examine our work settings to see the significant quality issues our profession faces every day. There are growing problem areas, including diseases such as diabetes affecting people of all ages, more people affected by cardiovascular disease, and poor outcomes regarding premature births. Nurses recognize that patient outcomes are integrally linked to implementing evidence-based interventions and that this concept is important to nurses and others. Our stakeholders—third-party payers, regulatory agencies, and the public—expect improved quality in healthcare and subsequently improved outcomes (Dang & Dearholt, 2018; Makary & Daniel, 2016). Scholars cite major barriers regarding the implementation of EBP in healthcare, such as lack of knowledge and skills (Melnyk, Fineout-Overholt, Gallager-Ford, & Kaplan, 2012). Nursing indeed needs to step up to meet this challenge, and it will do so as the prepared and educated DNP.
Next Steps in the DNP Journey
Because of this significant need to move newly generated knowledge to the bedside, we have a profound problem in our profession. In order to improve outcomes for our patients, we must bridge the gap between knowledge and practice. You, the DNP scholar, are moving forward as one of our new experts in closing the theory, nursing science, and practice gap! National focus given by the IOM calls us to address these quality issues and pushes us with a sense of urgency to bring the best research, the EBP findings, in the systematic reviews and clinical research to improve clinical outcomes. The goal of EBP is to use best evidence to create best practice. As you move through this program, you will increasingly focus on this process as you identify a practice problem, develop a practice question related to the problem, and complete an exhaustive evidence review that, when synthesized, answers the practice question. Furthermore, you’ll also understand how to critically appraise the literature you choose to implement.
Reference
Chism, L. A. (2019). The doctor of nursing practice: A guidebook for role development and professional issues (4th ed.). Burlington, MA: Jones & Bartlett.
Dahnke, M. D. & Dreher, H. M. (2010). Philosophy of science for nursing practice: Concepts and application. New York, NY: Springer Publishing Co.
Dang, D., & Dearholt, S. (2018). Johns Hopkins nursing evidence-based practice model and guidelines (3rd ed.). Indianapolis, IN: Sigma Theta Tau Internationa