DNP Program Outcomes and DNP Program Outcomes and Impact on PracticeImpact on PracticeElizabeth F. Fuselier, Elizabeth F. Fuselier, DNP,RN,APRN, BCDNP,RN,APRN, BC

Family Nurse PractitionerFamily Nurse PractitionerUniversity of Tennessee University of Tennessee Health Science Center, Health Science Center,

Memphis, TNMemphis, TN

Professional EvolutionProfessional Evolution

National Accounts Representative in National Accounts Representative in Workers Compensation 1988-1991Workers Compensation 1988-1991FNP Practicing in Rural & FNP Practicing in Rural & Occupational Medicine in MS and TN Occupational Medicine in MS and TN 1996-19981996-1998Lead Nurse Practitioner, Ochsner Lead Nurse Practitioner, Ochsner Clinic Foundation(OCF), New Orleans, Clinic Foundation(OCF), New Orleans, LA 1998-2005LA 1998-2005Clinical Practice, Department of Clinical Practice, Department of Internal Medicine, Emergency Internal Medicine, Emergency Medicine and Pediatrics at OCF 1998-Medicine and Pediatrics at OCF 1998-22052205

Responsibilities as Lead NPResponsibilities as Lead NP

Developed a practice model of NP Developed a practice model of NP utilization throughout OCFutilization throughout OCF

Created NP practice opportunities in Created NP practice opportunities in all departments except plastics and all departments except plastics and dermatologydermatology

Liaison for NPs to hospital and clinic Liaison for NPs to hospital and clinic administrationadministration

Responsibilities cont.(1)Responsibilities cont.(1)Created and implemented Created and implemented credentialing, hiring, and credentialing, hiring, and orientation policiesorientation policies

Developed evaluation and Developed evaluation and competency policies and toolscompetency policies and tools

Liaison to state, national, Liaison to state, national, governmental and professional governmental and professional organizationsorganizations

Served on medical residency Served on medical residency guidelines committeeguidelines committee

Responsibilities Cont. (2)Responsibilities Cont. (2)Advocated for and increased NP Advocated for and increased NP compensation, scope of practice, and compensation, scope of practice, and educational opportunities within OCF educational opportunities within OCF and statewide.and statewide.

Managed over 40 NPs, increased Managed over 40 NPs, increased overall staffing to 120 APRN’s overall staffing to 120 APRN’s

Worked with Lead Physician Worked with Lead Physician Assistant, CRNA, and NNP to continue Assistant, CRNA, and NNP to continue advancement of practice at OCFadvancement of practice at OCF

Transformation of PracticeTransformation of PracticeOCF became accredited as a OCF became accredited as a MAGNET hospital in 2003MAGNET hospital in 2003

Evolution from problem based Evolution from problem based healthcare to evidenced based healthcare to evidenced based patient and outcome focus model patient and outcome focus model

Clear mandates for increased nursing Clear mandates for increased nursing research, and clinician skill set to research, and clinician skill set to assess, incorporate and evaluate assess, incorporate and evaluate evidenced based clinical practiceevidenced based clinical practice

Transformation Cont. (2)Transformation Cont. (2)

Medical Residency restrictions Medical Residency restrictions developed and enforceddeveloped and enforced

Became clear that a transformation for Became clear that a transformation for NP practice was needed and NP practice was needed and opportunity was thereopportunity was there

In effort to lead, I had to lead by In effort to lead, I had to lead by exampleexample

Needed to become a clinical expert Needed to become a clinical expert beyond the masters levelbeyond the masters level

Transformation of Personal Transformation of Personal Practice ModelPractice Model

MSN skill set was in place, but a void MSN skill set was in place, but a void in broader repertoire of critical in broader repertoire of critical thinking and evaluation skills existedthinking and evaluation skills existed

Decision to seek a doctoral level Decision to seek a doctoral level education was madeeducation was made

Evaluation of available doctoral Evaluation of available doctoral programs was madeprograms was made

Making the Right ChoiceMaking the Right ChoiceChose University of Tennessee :Chose University of Tennessee :– Practice focused DoctoratePractice focused Doctorate– Distance learning program onlineDistance learning program online– 1:4 Ratio1:4 Ratio– 970 clinical hours 970 clinical hours

DNP offered a cross sectional didactic, DNP offered a cross sectional didactic, clinical, and administrative toolbox for clinical, and administrative toolbox for advancement to a higher level of clinical advancement to a higher level of clinical scholarship and practicescholarship and practice

DNP offered a practical model DNP offered a practical model

The Right Choice (cont)2The Right Choice (cont)2Program offered structured clinical Program offered structured clinical experience at a higher level than the experience at a higher level than the MSN to develop broader evidenced MSN to develop broader evidenced based scope of practicebased scope of practice

Provided the working language of Provided the working language of bench and clinical researchbench and clinical research

Fostered the development of a Fostered the development of a broader array of analytical, theoretical, broader array of analytical, theoretical, philosophical and evaluative processesphilosophical and evaluative processes

The Right Choice (3)The Right Choice (3)

The DNP provides the principles and The DNP provides the principles and lived experiences to become a nurse lived experiences to become a nurse leader in clinical,academic, leader in clinical,academic, administrative, community and administrative, community and policy making arenaspolicy making arenasThe DNP provides the didactics for The DNP provides the didactics for one to become a change agent to one to become a change agent to transform advanced nursing practicetransform advanced nursing practice

Lessons From the FrontLessons From the Front

Faculty provided critical networking Faculty provided critical networking resources to allow for superior resources to allow for superior clinical electives and residenciesclinical electives and residencies

Facilitated access to broad Facilitated access to broad opportunities and exposure to opportunities and exposure to exemplary nursing leaders across the exemplary nursing leaders across the healthcare spectrumhealthcare spectrum

Impact on Current PracticeImpact on Current Practice

Appointed the first full time DNP Appointed the first full time DNP faculty position at the University of faculty position at the University of Texas Health Science Center-Texas Health Science Center-Houston, November 2005Houston, November 2005

Assistant Professor in the Assistant Professor in the Department of Acute and Continuing Department of Acute and Continuing CareCare

Appointment Cont(2)Appointment Cont(2)

Appointed Executive Clinical Director Appointed Executive Clinical Director of University of Texas Health Servicesof University of Texas Health Services

Will participate in committee to Will participate in committee to develop innovative DNP and APRN develop innovative DNP and APRN practice opportunities practice opportunities

““Leadership Is Leadership Is both something both something

you are and you are and something you something you

do”do”Fred smithFred smith