Doctor of Nursing Practice (DNP) perceptions of leadership abilities and governance: clinical inquiry project

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Creviston, Jake E.
Oregon Health & Science University
Nursing; Clinical Governance; Policy Making; Leadership
thesis / dissertation description
The involvement of nurses at every level of healthcare decision-making is imperative to achieve the Triple Aim. The American Academy of Colleges of Nursing (AACN) (2006) states, “Doctor of Nursing Practice (DNP) graduates must be proficient in…creating and sustaining changes at the organizational and policy levels” (p. 10). The Institute of Medicine (IOM) (2011) states, “nurses should have a voice in health policy making and be engaged in implementation efforts related to health care reform” (p. 8). Oregon is engaged in significant healthcare reforms but nurses are underrepresented at decision-making tables. Nursing’s absence in policy development and implementation risks patient satisfaction, quality and cost. The DNP prepares nurses to lead policy development and implementation. A gap in the literature exists of whether DNPs feel adequately prepared for policy work and if, and at what levels, they are engaged. Thirty-four Oregon Health & Science University (OHSU) DNP graduates were surveyed on this topic. Most felt prepared for, and were engaged in, policy work at the institutional level, but several barriers to engagement beyond the institution, namely time, incentive, guidance and support, were cited. DNPs should seize leadership opportunities and negotiate for time and incentive to engage. Institutions should maximize DNP scopes and encourage policy development and implementation. Steps should be taken at the individual and institutional levels to maximize the role of the DNP as a leader in policy development and implementation.