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SPIN: Stimulating Practice Innovation Mary Terhaar, DNSc Krysia Hudson, DNP Carolyn Fowler, PhD
Martha Sylvia, PhD, MBA, RN
Inst
itute
Resources
Colla
bora
tion
Coaching
Have to compete
for funding
Struggle to repeat the cycle
of research
Have difficulty getting
published
Need to find collaborators
& build relationships
Asked to teach but
may not have learned to do
so
Mock, Nolan, Allen et al (2008)
Newly Prepared Doctorates Struggle
Strategies
1. Assessment DNPs Employers
2. Annual Institute
3. Online Community & Resource Center 4. SPIN Fellows Program
5. Enterprise-Wide DNP Council
Inst
itute
Resources
Colla
bora
tion
Coaching
ASSESSMENT Describe & Promote Outcomes
DNP Outcomes
Projects
CNO Survey
Employer Survey
Scholarly Work
Grad Surveys
Anecdotes
Assessment - DNPs
• What are DNPs doing?
• What challenges do DNPs experience?
• How can we mitigate barriers & threats?
• How can we be helpful?
Practicing DNPs
First Credential
0 2 4 6 8 10 12 14 16
AD
Diploma
BSN
43
Role
0 2 4 6 8 10 12 14 16
CNS Admin
Educator Informatician Public Health Health Policy
Safety & Quality Home Care
Care Management Other
43
NP Certification
0 1 2 3 4 5 6 7 8
Acute Care
Adult
Family NP
Family/Psych
Gero
Peds
Neonatal
Safety & Quality
Pedi Acute Care
26
CNS Certification
0 1 2 3 4 5 6
Acute care
Adult
Adult/Psych
Child & Adol Psych
Gero
Peds
Other
11
Location of Practice
0 5 10 15 20 25 30
Maryland
Virginia
New York
Pennsylvania
Kansas
Florida
Delaware
North Carolina
California
Puerto Rico
44
Publication After Graduation
0 5 10 15 20 25 30 35 40
Submitted
Acdcepted
Published
Book Chapters
Book Chapters
Other
Presentations After Graduation
0 5 10 15 20
None
One - two
Three or Four
Five or Six
Seven or more
Accomplishments • JHH Nursing Publication Award **** • Shirley Sohmer Award ** • MNA Pathfinder Award • Think Swiss Award • Assistant Professor Appointment ****** • Program Director **** • NLN Nurse Educator Certificate • Director of Nursing • CNO *** • Physician Collaboration Award • National Committee Chair ****
Compensation for Performance
YES 82%
NO 18%
33
Place of Employment
0 5 10 15 20 25 30
Academe
Hospital
Joint
Private Practice
Government
Other
Changed Employers
YES 23%
NO 77%
44
Promotion Post Graduation
YES 42%
NO 58%
43
New Title
0 1 2 3 4 5 6 7
CNO
Director
Assistant Professor
Lead NP
Cant Share
19
Reason for Changing Position
Opportunity 68%
Responsibility 16%
Relocation 5%
Prepare for Future
Promotion 11%
20
Teaching
Classroon 32%
Clinical 21%
Hospital 19%
Not Teaching 28%
43
New Responsibilities
• None
• EBP • Increased leadership • Publication • Translation Projects • Program Development • Precept DNP Students • Policy Development • QI
• Research
Very Often to Always
8 Advocate for colleagues 3.48
7 Advocate for patients 3.33
3 Provide organizational leadership to increase quality 3.30
18 Impact practice in your facility 3.25
1 Apply science to improve outcomes 3.23
2 Demonstrate organizational leadership (systems) 3.23
Very Often to Always 9 Use evidence to change policy 3.20
11 Collaborate with other disciplines to improve outcomes 3.20
5 Apply analytics to decisions 3.10
4 Demonstrate doctoral level clinical scholarship 3.0 5
10 Change policy to impro ve o utco mes 3.0 5
12 Lead collaborations between disciplines 3.0 5
14 Impact health in your facility 3.0 0
Occasionally
6 Apply information systems solutions to raise quality 2.8 3
13 Lead collaborations focused on prevention 2.75
15 Impact health in your community 2.55
16 Impact health nationally 2.0 8
19 Impact practice locally 2.6 8
20 Impact practice nationally 2.28
Almost Never
17 Impact health globally 1.8 3
21 Impact practice globally 1.9 5
Barriers
• Competing priorities 1.97 • Lack of funding 2.00 • Lack of time 2.03 • Lack of administrative support 2.31 • Lack of executive sponsorship 2.60 • Lack of statistics assistance 2.87 • Lack of IT resources 2.79 • Lack of data 3.21
The lower the score, the greater the difficulty
What organizational support would help?
Inst
itute
Resources
Colla
bora
tion
Coaching
Assessment - Employers
CNO Interviews - Methods
• Round 1: Survey refinement (respondent N = 1)
• Round 2: Survey administration and refinement (N=7)
• Round 3: Development of web-based CNO survey
• Round 4: Selected follow-up
CNO Interviews – Key Findings
DNP degree program is not well understood
“My greatest concern is the lack of understanding and appreciation of
what a DNP can bring to an organization. One of our greatest
challenges is educating the organization, and especially physicians,
about the DNP role and what advantages there are to the
organization”
CNO Interviews – Key Findings
DNP degree program is not well understood
“[A senior physician colleague] approached me in the hall and said:
‘I’m very concerned about nursing’s movement to produce all these
DNP’s. Nursing is better off having a few high-quality doctorally-
prepared students than an army of people with lesser qualifications’”
CNO Interviews – Key Findings Skills considered essential for DNP graduates working in
“I would expect them to be able to define leadership and know how to
assess [it] using various models.”
“[I expect them to be] able to operate at both a strategic and tactical
level.”
“They must be able to take on more complex system issues”
CNO Interviews – Key Findings Selected limitations of DNP training
“I definitely think there is a difference between the skills I would expect
them to have and what they are getting prepared for … because when I
looked at DNP programs … what they provide in leadership [training]
is very variable”
CNO Interviews – Key Findings
New themes
“They were shining stars before they did the DNP; they came back with
enhanced skills, and are even better than they were before.
The most successful had a crossover experience because she blended her
work and scholarly pursuit”
CNO Interviews – Key Findings
Selected limitations of DNP training
“I think it has been stronger in concept than in execution and I think it
has been stronger for nurse practitioners in advanced practice roles than
it has been for those going into executive or management roles”
CNO Interview Results
• Anticipation of DNPs contribution
• Desire to support DNPs
• Desire to put DNPs abilities to good work
• Connect DNP to mission & triple aim
Inst
itute
Resources
Colla
bora
tion
Coaching
Annual Institute
Provide all DNPs in Maryland the opportunity to
disseminate knowledge and increase
confidence so they will be effective in the
work of translation and innovation in practice.
SPIN
Initial
• 3 day program once a year
• Nice hotel
• Abstracts
• Un-conference
• Statistical Process Control
• Role transition
• N=50
Improved
• 2 day program twice yearly
• On campus
• Abstracts
• Un-conference
• Writing for publication
• Calculating ROI
• N=45
Inst
itute
Resources
Colla
bora
tion
Coaching
Online Community & Resource Center
• Develop and test social and professional network.
• Facilitate networking and collaboration among DNPs
across Maryland.
• Alpha testing by DNPs across Maryland in 2012.
• Refined in 2013.
Online Community
• In-House (JHU/JHH Community)
– Bubbler (JHED)
• State Wide
– Linked In
• Collaboration – Have we missed anyone?
Inst
itute
Resources
Colla
bora
tion
Coaching
DNP Council
• Establish a council at the Johns Hopkins Hospital – 40 DNPs across the Hopkins Enterprise
• Target practice problems • Design strategies to
– improve performance, – evaluate outcomes, and – develop careers
DNP Council
• Focus on strategic intent
• Collaborative efforts
• Collaborative publications
• Problem solving
• Identify and mitigate barriers
Your Thoughts?
Next Steps
• Collaborations
– Translation
– EBP
– Publications
– Consultations
Next Steps
• Planning for next conference…
• Use of social media
• Self Paced Learning Modules
This work was conducted with support of an NSP II award from the Maryland Health Services Cost Review Commission
IMPACT Start-up……
References
1. American Association of Colleges of Nursing. (2004). AACN Position Statement on the Practice Doctorate in Nursing. Washington, D.C.
2. Chang, S., Hughes, D.C., & Chamberlain, R.M. (2008). Works-in-progress: guiding junior scientists through career development applications. Journal of Cancer Education, 23(3): 142-148.
3. Dennis, K. (1991). Components of doctoral curriculum that build success in the clinical nurse researcher role. Journal of Professional Nursing, 7(3): 160-165.
4. Institute of Medicine. (2011). The Future of Nursing: Leading Change. Advancing Health. Washington, DC: The National Academies Press
5. Khalsa, D.C. & Pearson, N.J. (2007). Financial support for research training and career development in complementary and alternative medicine from the National Institutes of Health. Journal of Manipulative and Physiological Therapeutics, 30(7): 484-490.
6. Kirschling, J. (2014). Reflections on the Future of Doctoral Programs in Nursing. AACN Doctoral Education Conference. Naples, Florida.
7. Levy, G.S., Sherman, C.R., Gentile, N.O., Hough, L.J., Dial, T.H., & Jolly, P. (1988).Postdoctoral research training of full-time faculty in academic departments of medicine. Annals of Internal Medicine, 109 (1), 414-418.
References 8. Nolan, M.T., Wenzel, J., Han, H., Allen, J.K., Paez, K.A., Mock, V.. (2008). Advancing a
program of research within a nursing faculty role. Journal of Professional Nursing, 24(6): 364-370.
9. Nolan, S.A., Buckner, J.P., Marzabadi, C.H., & Kuck, V.J. (2008). Training and mentoring of chemists: a study of gender disparity. Sex Roles, 58: 235-250.
10. Pion, G.M. & Corday, D.S. (2008). The Burroughs Welcome Career Award in the biomedical sciences: challenges to prospects for estimating the causal effects of career development programs. Evaluation and the Health Professions, 31(4): 335-369.
11. Robinson, B. (2001). The dissertation and beyond: Developing your academic Career. ABNF Journal, 12(1): 17-18.
12. Rybarczyk, B., Lerea, L., Lund, P.K., Whittington, D., & Dykstra, L. (2011). Postdoctoral training aligned with the academic professoriate. BioScience, 61(9): 699-705.
13. Stefuriuc, I. (2009). Introduction: Building an academic profile – considerations for graduate students embarking on an academic career in political science in Europe. European Political Science, (8), 138-142.
14. Taleb, N.N. (2012). Antifragile: Things That Gain from Disorder. Random House. New York, NY.
15. Williams, C.A. (1988). Career development of the nurse scientist: The new doctorate faces a postdoctoral. Journal of Professional Nursing, 4(2): 73.