A DNP-prepared nurse can be more involved in strategic management decisions by aiding in the design of change plans and facilitating the inclusion and involvement of all stakeholders. DNP nurses can foster collaboration by modeling respect, transparency and establishing a clear pathway to achieve success (Rundio & Wilson, 2015). Change without a plan for ongoing engagement may result in regression to previous sub-par practices without widespread buy-in from the bedside nurses (Zaccagnini, 2015). Nurses are natural strategists as they identify, prioritize and implement complex plans of care for multiple patients with diverse needs, but nurses do not always recognize that they possess these skills. The DNP can build on this foundation and develop executive and collaborative skills that can navigate through a maze of obstacles to find an equitable solution for all that will advance the cause of health promotion.

The DNP nurse brings the combination of clinical expertise and academic prowess to translate and implement evidence-based interventions (Grove et al., 2015). Since the inception of the Affordable Care Act, healthcare reimbursement has transitioned from a basis of volume to one of quality (Sherwood & Barnsteiner, 2017). Subsequently, the focus of healthcare organizations is improving measurable quality outcomes and reducing harm, readmission, fraud, and abuse (Sherwood & Barnsteiner, 2017). One strategy for improving and developing a culture of safety is to encourage incident reporting for errors or near misses. Nurses should be encouraged to report all patient care or unit process concerns so that they can be investigated in a non-punitive manner to improve safety (Sherwood & Barnsteiner, 2017). Policies and procedures should be in place and subjected to regular review to ensure that they are still consistent with nursing board advisories. The DNP will study the data relating to quality measures and can use this to identify opportunities for process improvements. Once the improvement opportunities are identified, a literature search can provide evidence to support plans for a nursing process improvement. The DNP nurse can review the unit nurse’s standard of care and ensure that no cultural drift away from the best practice occurs.

References

Grove, S. K., Gray, J. R., & Burns, N. (2015). Understanding Nursing Research: Building an Evidence Based Practice (6th ed.). Elsevier

Rundio, A., & Wilson, V. (2015). The doctor of nursing practice and the nurse executive role (9th ed.). Wolters Kluwer Health. https://doi.org/https://bookshelf.vitalsource.com/#/books/9781496353825/cfi/6/6!/4/2/[email protected]:24.8 (Links to an external site.)

Sherwood, G., & Barnsteiner, J. (2017). Quality and safety in nursing: A competency approach to improving outcomes (2nd ed.). Wiley-Blackwell.

Zaccagnini, M. (2015). The doctor of nursing practice essentials (3rd ed.). Jones & Bartlett Learning.

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