EMERGENCY NURSES ASSOCIATION WHITE PAPER
The Essentials of Doctoral Education for Advanced Nursing Practice in Emergency Care
The Emergency Nurses Association (ENA) Board of Directors in consultation with the ENA Nurse Practitioner (NP) Validation Work Team approved the concept of the Doctorate of Nursing Practice (DNP) and the American Association of Colleges of Nursing’s Essentials of Doctoral Education for Advanced Nursing Practice (American Association of Colleges of
Nursing [AACN], 2004). The intent of this white paper is to review the definition of an advanced practice nurse (APN), present information regarding existing doctoral education in nursing, interpret the Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2004), and describe the ENA’s initiatives related to specialty-focused competencies.
APN Definition
The Emergency Nurses Association (ENA) defines an advanced practice registered nurse as a registered nurse who has completed a graduate degree in a specialty area of nursing and has a direct and/or indirect clinical practice in the specialty area (Emergency Nurses Association [ENA], 2007). The advanced practice registered nurse “… is prepared to assume responsibility and accountability for health promotion and the assessment, diagnosis, and management of patient problems which [may include] the use and prescription of pharmacologic and
non-only as clinical patient care experts, but the expanded roles of advanced practice registered nurses involve leadership, administration, consultation, education, and research (Chan & Garbez, 2006). APN is the umbrella term used to identify the advanced practice roles of the Clinical Nurse Specialist (CNS), Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA), and Certified Nurse Midwife (CNM).
Existing Doctoral Education in Nursing
“Research- and practice-focused doctoral programs in nursing share rigorous and demanding expectations: a scholarly approach to the discipline and a commitment to the advancement of the profession. Both are terminal degrees in the discipline, one in practice and one in research” (AACN, 2004). Examples of traditional doctoral programs in nursing include the following:
Research-focus
• Doctor of Philosophy (PhD) • Doctor of Nursing Science (DNS) • Doctor of Science in Nursing (DSN) • Doctor of Nursing Science (DNSc) Practice-focus
• Doctor of Nursing (ND) – no longer offered Hybrid of research and practice focus
The Doctorate in Nursing Practice (DNP) is an evolving model within advanced practice nursing. According to the AACN, “DNP education is by definition specialized, and DNP graduates
assume a variety of differing roles upon graduation. Consequently, a major component of DNP curricula focuses on providing the requisite specialty knowledge for graduates to enact particular roles in the larger healthcare system” (AACN, 2004). The eight competencies delineated in the DNP Essentials must be demonstrated by all graduates (AACN, 2004):
The Essentials of Doctoral Education for Advanced Nursing Practice
I. Scientific Underpinnings for Practice – based on nursing process, human behavior, and holistic care
II. Organizational and Systems Leadership for Quality Improvement and Systems Thinking – works with organizations and leadership to meet the needs of groups of patients and communities in order to promote patient safety and evidence-based best practice
III. Clinical Scholarship and Analytical Methods for Evidence-Based Practice – actively participates and utilizes research to advance health care
IV. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care – is proficient and utilizes information technology to advance health care
V. Health Care Policy for Advocacy in Health Care – advocates for health care through partnerships with government, institutional, and organizational agencies
VI. Interprofessional Collaboration for Improving Patient and Population Health Outcomes – collaborates with different health care specialties in the care of groups of patients and communities
VII. Clinical Prevention and Population Health for Improving the Nation’s Health – evaluates disease prevention and promotion and advocates for healthy lifestyles
VIII. Advanced Nursing Practice – establishes specializations through validation of competencies and skills
ENA’s Initiatives Related to Specialty-Focused Competencies
Emergency care currently supports the CNS and NP roles. The ENA has undertaken a Delphi study to verify and gain consensus on competencies and skills for nurse practitioners in emergency care. The ENA NP Validation Work Team has utilized the ENA’s Core
Competencies (ENA, 2000) as part of the framework for the Delphi study. Competencies and skills for NPs in emergency care are intended to supplement the National Organization of Nurse Practitioner Faculties (NONPF) 2006 Domains and Core Competencies (NONPF, 2006), which are recognized by the ENA Board of Directors and the NP Validation Work Team as the
foundation for all nurse practitioner practice. Future initiatives of the ENA include the validation and verification of competencies for the CNS in emergency care.
References
American Association of Colleges of Nursing (2004). The Essentials of Doctoral Education for Advanced Nursing Practice. Retrieved October 26, 2007, from
http://www.aacn.nche.edu/DNP/pdf/Essentials.pdf
American Association of Colleges of Nursing. (2006, May 24). Advanced Practice Nursing Consensus Work Group Report, May 2006 (Draft report from May 24, 2006 APRN Consensus Work Group meeting). Washington, DC: Author.
Chan, G. K. & Garbez, R. O. (2006). Education of advanced practice nurses for emergency care settings: Emphasizing shared competencies and domains. Advanced Emergency Nursing Journal, 28, 216-225.
Emergency Nurses Association. (2000). Emergency nursing core curriculum (5th ed.). Philadelphia: W. B. Saunders.
Emergency Nurses Association. (2007). Position statement: Advanced practice in emergency nursing. Des Plaines, IL: Author. Retrieved October 31, 2007, from
http://ena.org/about/position/
National Organization of Nurse Practitioner Faculties. (2006). Domains and core competencies of nurse practitioner practice. Retrieved October 31, 2007, from
Bibliography
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