Doctors of Nursing Practice and Interprofessional Collaboration

April 6, 2020

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Nearly a decade ago, healthcare agencies, think tanks, and medical professionals identified team-based interprofessional collaborative efforts between providers as essential components to improving patient outcomes and satisfaction.

Medical staff in meeting

The shift away from siloed healthcare (a system that has healthcare providers working independently of each other) has prompted the growth of dozens of action coalitions and national organizations that focus on collaborative work for common goals. At the center of the movement is an effort between the Robert Wood Johnson Foundation (RWJF) and the AARP, called Campaign for Action, that is working to encourage alliances among providers with diverse experiences, skill sets, and education.

As the largest segment of the U.S. healthcare workforce, this movement is essential for all nurses, particularly Doctors of Nursing Practice (DNPs) who are primarily focused on driving innovation, implementing policy changes, and improving evidence-based skills across the profession.

The Institute of Medicine (IOM) set the stage for multiple changes for the advancement of nursing practice, including the proliferation of DNP-educated nurses and the move to interprofessional practice. In its 2010 landmark “The Future of Nursing: Leading Change, Advancing Health” report, the IOM endorsed nurse leaders as “full partners, with physicians and other healthcare professionals.”

“Being a full partner transcends all levels of the nursing profession and requires leadership skills and competencies that must be applied both within the profession and in collaboration with other health professionals,” the IOM stated.

Team-based efforts have taken root in interprofessional education (IPE) and interprofessional collaborative practice (IPCP).

Healthcare Collaboration In Nursing

In the early years of modern professional nursing, healthcare professionals mostly worked independently. Providers often viewed patients in a vacuum, posing vastly different opinions and perspectives based on education, experience, specialty, and background. Such one-way communication failures often led to patient harm.

In the past few decades, several largely unsuccessful attempts have been made to encourage collaborative effort among healthcare providers. But in 2010 and 2011, the IOM and the World Health Organization (WHO) separately promoted interprofessional collaboration as an essential component to improving healthcare accessibility and quality. Shortly after, the Campaign for Action formed to encourage and track progress.

The campaign has assisted in creating action coalitions in all 50 states and the District of Columbia, made up of nurses, other healthcare professionals, patients, and other stakeholders.

A 2015 IOM progress report reviewing the collaboration efforts showed moderate success, validating the role of nurses as leaders and the importance of interprofessional collaboration. The progress report pointed out, “nurses cannot expand interprofessional collaboration or education alone.”

“Collaboration requires all members of a team working to their full potential on behalf of the patient and with respect for the contributions of other professions to the work,” the report stated. “Nurses need to be prepared to serve as a part of the team and to lead or coordinate efforts as appropriate.”

Since the 2015 progress report, the goal of interprofessional collaboration has branched to two concepts: practice and education.

“For health professionals, learning the skills to effectively work on IPCP teams is best gained through IPE, in which students from two or more health professions study together, so they can provide collaborative, safe, high-quality, accessible patient-centered care,” researchers wrote in “Interprofessional Collaboration and Education” in the American Journal of Nursing (AJN).

Advances in Interprofessional Practice Collaboration

AJN research found IPCP has the potential to impact healthcare concerns and outcomes in several positive ways, including the following:

Improving healthcare quality and safety

Multiple studies show a lack of communication between providers can be detrimental to patients due to avoidable medical errors and poor quality of care.

Decreasing healthcare professional shortages

Analysts say the anticipated shortage of thousands of physicians, nurses and other medical professionals could be quelled by practicing team-based care that allows for nurse leadership.

Establishing core competencies in education

Four core principles for IPE, created by the Interprofessional Education Collaborative (IPEC), can improve health outcomes. The principles are as follows:

Work to maintain a climate of respect and shared values.
Promote population health and healthcare needs by utilizing professional knowledge.
Communicate in a “responsive and responsible manner” to promote positive medical outcomes.
Apply the concept of team and teamwork to deliver healthcare, policy, and programs in a safe and timely manner.

Advances in Interprofessional Education Collaboration

Interprofessional collaboration efforts in education are not exclusively focused on novice healthcare workers. Experts say nurses and doctors who have extensive experience must be retrained to learn new communication techniques.

The push is intended to encourage health professionals to expand and explore the margins of their practice, the ANA stated. IPE also encourages “responsibility, accountability, coordination, communication, cooperation, assertiveness, autonomy, mutual trust, and respect,” the ANA said.

Several studies suggest progress has been made in IPE. One study, published in the Journal of Nursing Education, found partnerships between DNP and nursing Ph.D. students can reinforce the expansion of new nursing knowledge and evidence-based practices.

“Although different in purpose and education, Ph.D. and DNP programs should prepare students to collaborate throughout their careers,” the 2017 study found.

The leading nursing programs nationwide also recognize the importance of interprofessional collaboration in education and practice. A research study at Duquesne University found an interprofessional collaborative course for nursing and pharmacy students fostered IPEC core competencies in education.

Lynn Coletta Simko, Ph.D., and a Duquesne University clinical associate professor in the School of Nursing, and research partners discovered that the IPE course gave a new perspective to both the nursing and pharmacy students and “significantly increased their knowledge and understanding of the importance of the other profession’s role.”

About Duquesne University’s Online Doctor Of Nursing Practice Degree Program

Healthcare leaders at Duquesne University are continually working to improve interprofessional collaboration in education and clinical practice. The University’s Interprofessional Education Collaborative Committee and 2018-2023 strategic plan focuses on expanding cooperative learning across the academic and health sciences programs.

Duquesne University online DNP students learn about advanced nursing practice from experienced professionals who understand the challenges of the future of healthcare and want to work for improvements. Online DNP students learn evidence-based skills and practices to improve health outcomes for patients.