The DNP Degree as Entry into Advanced Practice

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When it was introduced in the 1990s, the Doctor of Nursing Practice (DNP) degree was promoted as a way for advanced practice registered nurses (APRNs) to earn the clinical expertise that goes into higher-level nursing. In the past decades, thousands of APRNs have earned a DNP degree, taking advanced roles in hospitals, medical centers and private practice.

In many respects, the DNP degree is what makes an effective nurse manager. DNP coursework trains advanced practice nurses in the skills needed to work as clinical healthcare leaders. The increasing complexities in the healthcare system, from the growing concerns about patient safety to the increase in chronic conditions, make practice expertise essential to population health.

The DNP degree has become so crucial to nursing that the American Association of Colleges of Nursing (AACN) recommends doctoral education be the entry into APRN practice, and the National Organization of Nurse Practitioner Faculties (NONPF) committed to supporting the training for entry-level nurse practitioner (NP) practice. At the same time, other nursing organizations, including the National Organization of Clinical Nurses (NOCN) and the American Association of Nurse Anesthetists (AANA), support the DNP for entry-level practice to advanced nursing.

The American Nurses Association (ANA) said DNP-prepared nurses often serve dual roles to impact both patients and the overall healthcare system positively. They work in public health, leadership, quality improvement and knowledge translation.

“The DNP prepares graduates to practice at the most advanced practice level and to create evidenced-based strategies through the application of new knowledge to improve clinical practice, which results in optimizing health outcomes,” researchers said in, “The Impact of the Role of Doctor of Nursing Practice Nurses on Healthcare and Leadership.”

As such, the DNP degree has become much sought after by APRNs seeking to advance their careers in healthcare systems, clinical practice and healthcare policy, among others. To earn the degree, either through a traditional classroom setting or an online DNP program, APRNs must adhere to standardized competencies.

APRN Doctoral-Level Competencies

In educating APRNs to earn a DNP degree, nursing organizations identified observable, realistic and measurable competencies as a framework for success in the educational program, the AACN stated. The organization outlined eight domains that are expected of DNP graduates:

1. Patient Care

In the course of their work, APRNs are expected to design, deliver, manage and evaluate comprehensive and broad patient care, the AACN stated. Doctoral-level competencies for APRNs include gathering and interpreting patient and clinical data to make a diagnosis in patients with multiple co-morbidities, including developing therapeutic interventions and crafting education and counseling plans.

2. Knowledge of practice

DNP-educated APRNs should be able to take scientific knowledge from a variety of sources and translate the information into practice. The work should include applying theoretical, scientific and evidence-based concepts to clinical practice.

3. Practice-based learning and improvement

APRN practice also includes the ability to critically self-evaluate and continually improve patient care based on lifelong learning. To reach this goal, APRNs should routinely reflect on their practice and seek feedback from other professionals and the patient population.

4. Interpersonal and communication skills

Working as a DNP-educated APRN also includes demonstrating skills to effectively communicate with patients, their families and other care providers across varied socioeconomic and cultural backgrounds, particularly during complex and challenging situations.

5. Professionalism

APRN work at the doctoral level includes acting professionally with strict adherence to ethical principles. Such behavior includes delivering compassionate care that follows ethical and moral guidelines in complex healthcare situations.

6. Systems-based practice

As DNP-educated leaders, APRNs must demonstrate leadership that improves healthcare systems and outcomes on a micro and macro level. Improvements can include stewardship of financial resources for the delivery of quality care and policy changes that will shape and optimize access to healthcare.

7. Interprofessional collaboration

As members of interprofessional teams, APRNs should be able to utilize safe, effective and collaborative patient-centered care that integrates the patient’s preferences.

8. Personal and professional development

A DNP education also requires APRNs to commit to lifelong learning and development that will advance professional and personal growth. This type of development can be achieved by incorporating health and stress-relief strategies into everyday life.

The AACN also said a highly educated nursing workforce, including DNP-degree graduates, is better equipped to lead to patient outcomes.

“Nurses with graduate-level preparation are needed to provide high quality care; conduct research; teach online, across clinical settings, and classroom; shape public policy; lead health systems; consult with corporations; and implement evidence-based solutions that revolutionize healthcare,” the AACN said in its “Academic Progression in Nursing: Moving Together Toward a Highly Educated Nursing Workforce” white paper. “These providers are in great demand to fill established and emerging roles that allow nurses to focus on a variety of practice areas, such as geriatrics, pediatrics, public health, informatics, systems improvement, and genetics/genomics.”


Earning a DNP Degree for Advanced Practice

Because the DNP degree is considered a gateway into work as an APRN, RNs are increasingly being encouraged to seek higher education. At Duquesne University, the online DNP program enables RNs to work toward improving health outcomes in their communities.

As a leader in online nursing education, Duquesne University’s DNP program offers concentrations in nursing education, forensic nursing and transcultural nursing, opening doors for APRNs to work as family nurse practitioners (FNPs), nurse educators and forensic nurses, among other positions. Many of the Duquesne University online nursing graduates go on to roles in healthcare policy, education, administration and management.

About Duquesne University’s Online DNP Program

Duquesne University’s online DNP program also prepares APRNs to work at the highest level of clinical leadership and innovate novel models for patient care. All Duquesne University DNP students are encouraged to use evidence-based practice models to improve policy and develop initiatives that will advance care delivery.

Duquesne University’s online DNP program is tailored for students who have professional and family responsibilities but also desire an advanced degree. For more information, contact Duquesne University now.




DNP Fact Sheet: AACN

A critical examination of developments in nursing doctoral education in the United States: NCBI

The Doctor of Nursing Practice Degree: Entry to Nurse Practitioner Practice by 2025: NONPF

The Impact of the Role of Doctor of Nursing Practice Nurses on Healthcare and Leadership: Medical Research Archives

Common Advanced Practice Registered Nurse Doctoral-Level Competencies: AACN

Academic Progression in Nursing: Moving Together Toward a Highly Educated Nursing Workforce: AACN