The delivery of health care has undergone major changes over the past five years in terms of technological/informational shifts, healthcare reimbursements, an increase in health care expenditures, a shortage of health care providers, and growing disparities in healthcare delivery, access, and outcomes. It is clearly evident that the delivery of health care now, more than ever before, requires expert nurse clinicians and nurse leaders to design, implement, and critically evaluate the multiple contexts in which health care is managed.
Therefore, nurses are needed who are prepared at the doctoral level in economics, informatics, epidemiology, evidenced-based research practices, and healthcare outcomes to design programs of care that are economically feasible, acceptable to the populations they serve, and which will impact the health of diverse populations.
To answer this need for expert nurses and clinical leaders, a practice-focused doctorate degree (DNP-Doctor of Nursing Practice) was developed as an alternative to the research-focused degree, the PhD (American Association of Colleges of Nursing, 2004). The PhD degree has been and will continue to be important in its ongoing pursuit of building a strong knowledge base for nursing. However, due to the growing complexities of healthcare access and delivery, masters prepared advanced practice nurses cited a need for more information on health policymaking, healthcare economics, information technology, advanced diagnoses and management, and evaluation of evidence-based research and its application to the problems they were facing.
Therefore, the practice-focused doctorate program was developed to answer that need by placing a greater emphasis on practice rather than theory, to answer questions of health disparities, health promotion/disease prevention, and national/global health concerns.
The notion of a practice-focused doctoral degree is not new. Other professional disciplines offer practice-focused degrees as entry level degrees into advanced practice [e.g., the Doctor of Pharmacy (PharmD.), The Doctor of Physical Therapy (DPT), and the Doctor of Psychology (PsyD)]. There are thousands of masters-prepared nurses who are working in advanced practice. The DNP degree would assist advanced practice nurses to obtain parity in educational preparation with other healthcare disciplines, thereby providing equal leadership and interdisciplinary team opportunities.
The American Association of Colleges of Nursing (AACN) and the National Organization of Nurse Practitioner Faculties (NONPF) believe that the DNP will improve our national and global health, as DNP graduates have a better understanding of healthcare systems. These two organizations believe the DNP should be the entry level into advanced nursing practice. With that thought, AACN is targeting the year 2015 as the date that advanced nursing practice education be at the DNP level to enter advanced practice.
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