DNP Essentials

Example within my work area (a hospital-based cardiac unit): In my unit, there was a high rate of hospital-acquired pressure injuries among patients with complex cardiac conditions. Rather than just implementing standard protocols, a DNP-prepared nurse could lead a project to address this. The nurse would not only review the existing evidence on pressure injury prevention but also integrate knowledge from other sciences. They might use biophysical science to understand the impact of hemodynamic instability on tissue perfusion, organizational science to analyze staffing and workflow issues, and psychosocial science to assess patient and family engagement in care. This holistic, scientifically grounded approach allows them to develop a more effective, multi-faceted intervention, such as a new protocol that combines specialized mattress technology with a staff education program on patient repositioning and a system for real-time monitoring of high-risk patients.

Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking

This essential prepares DNP graduates to lead in healthcare systems to improve the quality of care and patient safety. It focuses on the ability to develop, implement, and evaluate care delivery approaches based on scientific findings, using business, finance, and policy principles. The DNP-prepared nurse ensures accountability for quality and safety and can facilitate meaningful organizational change. They view the healthcare system as a whole, understanding that quality improvement is a complex interplay of people, processes, and technology.

Example within my work area (a hospital-based cardiac unit): Building on the previous example, the DNP-prepared nurse would utilize systems thinking to tackle the pressure injury problem. Instead of blaming individual nurses for not turning patients, they would analyze the entire system. They might identify that nurses are too busy with medication administration and documentation to perform timely repositioning. They would then propose a system-level solution, such as a new workflow that incorporates a "turning buddy" system or technology that alerts staff to a patient's need for repositioning. This work would also involve a business case analysis to show that the cost of preventing pressure injuries is far less than the cost of treating them. The DNP nurse would then lead a multidisciplinary team, including physicians, physical therapists, and hospital administrators, to implement and evaluate this quality improvement initiative, demonstrating leadership and systems-level change.

Sample Answer

The two DNP Essentials I will describe are Essential I: Scientific Underpinnings for Practice and Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking.

Essential I: Scientific Underpinnings for Practice

This essential focuses on the application of nursing science and other relevant sciences (such as biophysical, psychosocial, and organizational sciences) to the highest level of nursing practice. It is about using theory and scientific concepts to evaluate and enhance healthcare delivery and improve patient outcomes. A DNP-prepared nurse with this essential does not just follow evidence-based guidelines; they critically analyze the scientific basis of their practice, integrate knowledge from multiple disciplines, and contribute to the evolution of nursing science. They bridge the gap between scientific research and clinical practice.