Using effects-based reasoning to examine the DNP as the single entry degree for advanced practice nursing.

Abstract In October 2004 the American Association of Colleges of Nursing (AACN) endorsed the Doctor of Nursing Practice (DNP) as the single entry degree for advanced practice nurses (APNs) beginning in 2015. This action initiated significant changes in many graduate nursing programs. Currently 153 DNP programs have enrolled students and an additional 106 programs are in varying stages of development. This article will examine real and potential outcomes of having the DNP degree as the single entry level for APN practice using an effects-based-reasoning framework. The author begins with a discussion of factors that influenced the DNP initiative and an explanation of effects-based reasoning. Within an effects-based framework, the author examines acceptance or rejection of the DNP initiative by APN programs and professional organizations, as well as the effects within the broader healthcare community. Concluding observations will be shared. Citation: Rhodes, M., (June 27, 2011) "Using Effects-Based Reasoning to Examine the DNP as the Single Entry Degree for Advanced Practice Nursing" OJIN: The Online Journal of Issues in Nursing Vol. 16 No. 3. DOI: 10.3912/OJIN.Voll6No03PPT01 Keywords: Effects-based reasoning, Doctor of Nursing Practice degree, advanced practice nursing, leadership and change, nursing, nursing education, graduate education in nursing, practice doctorate, clinical doctorate, nursing leadership In October 2004, the American Association of Colleges of Nursing (AACN) endorsed the Doctor of Nursing Practice (DNP) as the single entry level education for advanced practice nurses (APN), effective 2015 IAACN. 2004I. The AACN is comprised of 660 nursing school deans IAACN. 2011ai. The AACN mission is to serve the public interest by setting standards, providing resources, and developing the leadership capacity of member schools for the purpose of advancing nursing education, research, and practice IAACN. 2010I. According to the U.S. Health Resources and Services Administration (HRSA) (2010), approximately 8.2% of the over three million registered nurses in the US are APNs. They practice in the roles of certified registered nurse anesthetists (CRNAs), certified nurse midwives (CNMs), clinical nurse specialists (CNSs), and nurse practitioners (NPs). The endorsement and subsequent publication of the AACN DNP Road ma ? Report (2006) launched a plan for transforming graduate nursing education. It initiated a change process that will continue to impact schools of nursing, as well as university and state educational systems, credentialing systems, and healthcare delivery systems for some time (Fulton & Lyon, 2005). The AACN endorsement of the DNP initiated a plan to change the education of advanced practice nurses. However, according to leadership and change theory, the AACN cannot control or guarantee the outcomes or effects of this plan iPascale. Millemann. & Gioia. 2000: Pulian. 2001I. The AACN does possesses influence over schools of nursing that constitute the membership of the AACN and that seek accreditation from the Commission of Collegiate Nursing Education, an autonomous, accrediting arm of the AACN (2010). However, the authority to add or remove degree programs lies with the university or state higher education organization (Cartwriqht & Reed, 2005"). As an organization, the AACN can certainly recommend changes in laws to transform state nurse practice acts, but does not have the authority to license advanced practice nurses. Licensing authority belongs to state regulating agencies, governed by state legislatures. This lack of authority naturally limits the ability of the AACN to control the outcomes of the plan. In the seven years since this endorsement the number of DNP programs has grown to 153 and an additional 106 programs are in varying stages of implementation IAACN. 2011bi. However, questions and concerns about the DNP as the single entry degree for advanced practice nursing persist IBrown-Benedict. …