MUSC Graduate Nursing ProgramPost BSN-DNP

Robin L. Bissinger, PhD, APRN, NNP-BC, FAANAssociate Dean of Academics

Programs of Study• The Graduate Program has multiple points of

entry– Post-baccalaureate RN to MSN

• ANP/FNP/PNP– Post-baccalaureate RN to DNP

• ANP/ FNP/PNP – Post-MSN to DNP

• Advanced practice nurses and nursing administration practitioners who have completed a master’s degree. However, nurses with a PhD could also seek the DNP

• Nursing Education Courses

DNP Program• Full or Part time plan of study

– Signed and agreed to by the student• If you change from FT/PT or PT/FT we have to revise

and sign a new plan of study• This can delay graduation in some cases

• Your program plan is used to register for you for your courses each semester– Any questions related to your program come to Arly

Douglass and Dr. Gigi Smith. – Dr. Gigi Smith is your program advisor– Course issues are addressed first with faculty, then your

advisor and if you cannot resolve the issue contact me.

Landmark Points and Progression(BSN to DNP)

• Completion of – Graduate Core courses with 85% or better– Assessment across the lifespan

• Mandatory Assessment immersion– Pharmacology (Broad Category of drugs)– Pathophysiology across the lifespan

• Completion of all three clinical courses– Mandatory Immersions for each

• Completion of Role Practicum• Completion of all APRN clinical hours

– 810 total hours

Key Site and Preceptor issues

• Students secure their own clinical sites– Can use AHEC placement for clinical courses– May have to travel

• Patient volume is adequate to ensure sufficient patients per day for student to acquire the skill needed to meet core curriculum guidelines, program goals, and practice in a work environment upon graduation

• Must have some time with an APRN preceptor

DNP Program Specific• Practice Inquiry Project• Residency

– MyFolio• Reflective Journaling• Scholarly Activities• Competencies

– Clinical Hours• Emphasis on independent and interprofessional

clinical practice

Professional Portfolio Development

• Maintenance of a professional portfolio (My-Folio)– Reflects students self-responsibility in their own

learning,– Constructs how competencies are met, – Is guided by faculty in some courses

• Project to get you started– Upload your CV– Upload a jpeg picture

• Contact Arly Douglass if you have any problems with access or uploading.

Practice Inquiry Project• The project is designed to solve practice The project is designed to solve practice

problems or inform practice directions. problems or inform practice directions. – Implements innovations in clinical practiceImplements innovations in clinical practice– Applies evidence-based interventionsApplies evidence-based interventions– Proposes changes to care delivery models Proposes changes to care delivery models

• The scope of change, which is initiated within a The scope of change, which is initiated within a system, should have the potential to impact a system, should have the potential to impact a vulnerable population. vulnerable population. – Practice change initiativePractice change initiative– Program implementation and evaluationProgram implementation and evaluation– Practice model implementation and evaluationPractice model implementation and evaluation– Health Policy implementationHealth Policy implementation– Quality Improvement ProjectQuality Improvement Project

Guidelines

• Project is related to advanced practice in the nursing specialty and benefits a group, population or community rather than an individual

• May be done in partnership with an agency or group but student must have the leadership role or can be solo

• Students work with a clinical expert or mentor and the Residency Faculty

• Must go through IRB at MUSC and your center• Ask yourself “What population or outcome will you

impact with this change” and how will you know….what data will you look at pre and post change.

PIP Framework• Focus-PDSA approach

– F: Find a process to improve• What do you plan to change

– Organize an effort to work on improvement• Who will be involved and what support do you need

– Clarify the current knowledge of the process• What is the current state of the science related to the

process or practice– Understand process variation and performance capabilities

• Outline specifically how the current process works– Select changes aimed at performance or process improvement

• Choose the intervention or interventions• What changes are you going to make

PIP Framework• Plan the change. Analyze and predict the results

– How do you plan to measure the effect of the change• Do it

– Execute the plan taking small steps in controlled circumstances

• Study it– Check or study the results

• Act: Take action– How do you sustain the gain– If no working what is the next step (Continue PDSA)

Practice Inquiry Project• Faculty-guided scholarly experience

– Demonstrates evidence of critical thinking and ability to apply research principles

• Topic chosen by the student• Built on-line within the portfolio and some

sections will be approved as it is developed. • The development of the portfolio is a “thread” that

runs through the courses. – Some courses interconnected “to be continued” in

the development of the Practice Inquiry Project and must be uploaded to the my-folio (portfolio).

Practice Inquiry Project Course Development– Scientific UnderpinningsScientific Underpinnings

• Theory PaperTheory Paper– Evidence Based Practice Quality and SafetyEvidence Based Practice Quality and Safety

• CITI• State of the Science• Evaluation and Synthesis Table

– Applied Health Care Economics and Finance• Cost benefit/cost effective analysis

– Practice Inquiry and IRB• Project Proposal• IRB proof of Submission• IRB Approval• First draft of paper

PMB Launcher.lnk

Practice Inquiry Project Course Development

• Applied Epidemiology and Biostatistics– CDC completion certificate

• Advanced Health Policy and Advocacy– Final Policy Project

• Residency– Copy of final poster– Final paper for publication– Proof of submission from Journal

Practice Inquiry Project Committee• Consists of two (2) members

– MUSC Residency Faculty – Clinical Advisor/Mentor/Expert at the site in which the

project is being done• The post-BSN/DNP students must pick their practice

inquiry committee members by the fall of their second year. • Need to identify your topic by Fall of your second year and

write you State of the Science based on your project in the EBP course.

DNP Residency• Residency Hours• 400 Hours400 Hours

– 100 Indirect hours (Project work and IRB)100 Indirect hours (Project work and IRB)– 300 Direct hours (clinical practice hours)300 Direct hours (clinical practice hours)

• Supervision by FNP/PNP/ANP facultySupervision by FNP/PNP/ANP faculty• Time spent in area of specialization doing patient care Time spent in area of specialization doing patient care

at DNP levelat DNP level– Further synthesis and expansion of learning demonstrating Further synthesis and expansion of learning demonstrating

competency in an area of nursing practice.competency in an area of nursing practice.– 150 hours must be in primary care with further expansion of 150 hours must be in primary care with further expansion of

work and focus on population issueswork and focus on population issues– On-line clinical logOn-line clinical log

» Diagnosis and Procedure trackingDiagnosis and Procedure tracking

• Any clinical time related to DNP projectAny clinical time related to DNP project

Residency Contract• Purpose of residency is to increase exposure to doctoral

level clinical practice– DNP Clinical Residency Contract

• Specific objectives, requirements and evaluation criteria– Specified number of hours for each contract– Completion of contract to successfully meet residency

requirement» Final decision by residency course coordinator

• Contract must be developed by the student and agreed on by clinical preceptor and residency course coordinator

• Signed by the student, clinical preceptor and residency course coordinator.

– Placed in academic record– Must demonstrate completion of contract and upload to my-

folio unless in Typhon• Contracts can take the entire semester so get started

Residency (Fall/Spring Year 3)– Clinical Site

• Clinical Site Approval form– Faxed to Graduate Program Coordinator (Douglass)– Goes to Residency Coordinator for Approval

• Once site approved: Affiliation Agreement Request Form

– Faxed to Graduate Program Coordinator• Must have Legal facility agreement to start residency

work– Clinical Preceptor

• With expertise in clinical practice and Nationally certified• Complete clinical preceptor form, attach CV, copy of

license and certification – Faxed to Graduate Program Coordinator: Douglass

Residency Contract• Purpose of residency is to increase exposure to doctoral

level clinical practice– DNP Clinical Residency Contract

• Specific objectives, requirements and evaluation criteria– Specified number of hours for each contract– Completion of contract to successfully meet residency

requirement» Final decision by residency course coordinator

• Contract must be developed by the student and agreed on by clinical preceptor and residency course coordinator

• Signed by the student, clinical preceptor and residency course coordinator.

– Placed in academic record– Must demonstrate completion of contract and upload to my-

folio unless in Typhon

Residency Evaluation

• Evaluation of Clinical site• Evaluation of Clinical Preceptors• Evaluation of Residency Course• Evaluation of Residency Course Coordinator• Preceptor evaluation of you

– Long and short forms

Residency Competencies• Domains and Competencies for DNP education and

APRN practice must be met within the program. – These are the skills, knowledge and attitudes required for

clinical practice (referred to as competencies)• Some are met in course work• Others are met by students with documentation provided

by you in MyFolio• Each Domain and competency is outlined in MyFolio

– Required to review competencies and complete any tasks– Example

• Competency 22: Counsels the patient on the use of complementary/alternative therapies (see task)

– In one paragraph describe how you counseled a patient on the use of complementary therapies.

MyFolio: Reflective Journal• Integration of clinical leadership and inquiry into previous

or current practice– Utilize clinical cases from your experience or practice– Integration of ethics, genetics, heath policy, collaboration and

information technology, health disparity and other areas of doctoral level practice

– This is a tangible, deliverable academic product– Example

• Identify a potential genetic risk in a population of patients you have cared for and discuss a diagnosis of a genetic condition and an intervention you made for an individual in your practice. Discuss the implications for the families. What did you learn from the experience? Would you do anything different? Provide a critical analysis and discussion.

– Done in MyFolio under Reflective Journaling

MyFolio: Scholarly Activities

• Academic and Scholarly activities– Conferences, seminars, journal club, grand rounds,

morbidity and mortality, patient conferences, quality and safety, practice-based lectures, interdisciplinary committees, quality improvement committees, policy or advocacy events

– Each student is expected to document a minimum of 10 activities during the program and/or residency

• Start now and keep it up….– On My-Folio: under Residency you will find this

section

Residency I• Project cannot be started until you have IRB approval

and you must be in your residency course• Project

– Upload 5 page edited paper proposals with changes in my-folio

• Share this with your residency faculty– Choose your journal– Write first section of your paper up to results/conclusion– Stay on time-line and redo it if delay in IRB

• Complete half of your clinical hours– Insure clinical contracts are completed, hours verified and

upload• Complete half of your scholarly activities, reflective

journaling and competencies

Residency II• Project

– Write final paper, obtain faculty approval and send to journal

• Upload journal has received it • Upload paper that was sent for publication

– Develop poster and seek approval prior to presentation

• Meet with statistician early if needed• Complete remaining clinical hours

– Insure clinical contracts are completed• Complete remaining scholarly activities, reflective

journaling and competencies • If any delays discuss need for another residency

Final Project Work• Final proposal is completed in NRDNP Project Inquiry

and IRB– First draft of paper that outlines project is reviewed by faculty

and uploaded after all changes are made• Final paper and poster are due in your last residency

(NRDNP 890)• Two weeks prior to the poster presentation

– All sections of MyFolio must be complete– Publication must be approved and all revisions made

• Poster presentation– Electronic publication must be uploaded with proof of

submission to journal– Poster is presented with a 10 minute oral-summary– Committee signs off on your work with recommendation for the

DNP degree

Contact us

• Stay in touch• Send emails with questions and concerns• Consider being on the Graduate Program Committee and

EPEC committee to represent your group• If you are struggling call early so we can help• Understand one thing:

– “Our Goal is that everyone will graduate, do well and represent the CON as a strong APRN leader”

• Follow up with us after graduation: Alumni survey, employer survey and graduation survey

QUESTIONS?