• Describe the 3 AACN DNP Essentials that most align to the completion of a Doctoral Project. Be specific. Note: This is in general terms, not in relation to a particular quality improvement or organizational goal.
• Explain how the AACN DNP Essentials will relate to the completion of a practicum/field experience. Be specific.
Describe the 3 AACN DNP Essentials that most align to the completion of a Doctoral Project. Be specific.
This criterion is linked to a Learning OutcomeExplain how the AACN DNP Essentials will relate to the completion of a practicum/field experience. Reducting admission. Be specific.
AACN Competencies and the Walden Mission, Vision and Outcomes
Professional and Academic Goals Aligned with Walden’s vision, mission,
It has been observed that the nurse foundation for quality of care can negatively affect the nurses’ career success. Thus, pursuing a master’s or doctoral level degree can help strengthen nurses’ role in dealing with hospital affairs and teamwork collaboration (Wang et al., 2019). I have been practicing as a nurse for a while, and this is the right time to pursue further studies to polish my skills as an Advanced nurse practitioner. The DNP program offered by Walden university is a terminal degree for students who are pursuing nursing as their field of practice. Since it is the highest degree program thus, the major aim of this program is to not only train the pupil according to the field of specialty they opted for but also provide them with training on general grounds to make the most competent nurses with refined skills. American Association of Colleges of Nursing recommended DNP as a terminal degree for obtaining recognition of nursing as a profession and an independent discipline (AACN, 2006).
I have always wanted to be a public health advocate, and finding solutions to health disparities and cultural differences is my career goal. As a DNP graduate, I will be able to practice my expertise and can apply advanced knowledge to bridge the gap between theory and practice.
Waldens’ vision of providing a knowledgeable degree that can produce well-equipped nursing students capable of finding solutions to societal challenges efficiently and effectively for the betterment of the globe has inspired me to enroll in this institute. The university’s mission is to provide a versatile platform that offers a diverse range of careers and opportunities to become a knowledgeable individual capable of imparting positive social change (Walden University, n.d.). Walden’s goals reflect that I can become an expert in my field while making it contextual to our cultural diversity and social values. Walden, at its institute, has a social focus on empowering students to exhibit positive social change. By social change, Walden means a deliberate process involving action and strategies to improve human and social conditions. Walden incorporates social change by training students into well-civilized, highly qualified, and ethically practicing scholars.
The World Health Organization defines determinants of health as the environment provided to people to have birth, grow, live, work, age, and the integration of health facilities. These determinants are based on monetary matters, power, and resources globally and at national and local levels (WHO, 2013). The institute of social determinants of Walden university is specifically established to train individuals who will become leaders of social change and will be able to bring solutions to health equity and socioeconomic status differences affecting the distribution of social determinants in their population.
Professional and Academic Goals Aligned With Social Determinants of Health
Since practicing as a nurse, I have aimed to bring justice to nursing practices by providing equal quality services to all individuals from various ethnic backgrounds, of any age and gender, and irrespective of their socioeconomic status. Studying at Walden university will help me refine my decision-making skills and find solutions to health disparities and ways of bringing positive social change in our society. Minnesota department of health reflects that out of the licensed nurse practitioner, only 10% of them are serving in a rural area (Minnesota depart of health, 2015). I want to contribute to this percentage of nurses serving the disadvantaged population to improve the overall health status of my community.
Professional and Academic Goals Aligned With AACN DNP Essentials
The essential of doctoral education for ANP covers two aspects: the general DNP competencies and specialty-related competencies. In general competencies, the first essential is the scientific underpinning of life process principles, human behavior patterns, and processes bringing positive change in community health status and understanding the relationship of human health with its environment; this essential inculcates better knowledge of the complexity of practice and will provide me a conceptual base for better practice. The second essential teaches leadership qualities for quality improvement and system thinking. This will encompass the development of skills to mitigate health disparities, enhance patient safety and achieve excellence in my practice. The third essential is promoting evidence-based practice; through scholarship programs and research, I can contribute to the nursing field by providing evidence-based better practices, forming improved policies, and leading to high-quality services. The fourth essential focus is on the latest technological advancement, thus influencing us to transform the health care system. The fifth essential highlights the significance of advocacy for speaking about the nursing field’s needs to help improve health service delivery policies; this supports my idea of public health advocacy. The sixth one suggests improving interpersonal collaboration to make a strong team leading to better outcomes; communication skills are key to my achievements. The seventh essential also serves for public health improvement through health promotion and prevention programs. Eighth states that no individual can become a master of all skills; as we move up in the hierarchy, the complexity increases; thus, specialty-specific competencies need to be incorporated for better training of the students going in specific fields. Teaching them how to conduct a comprehensive assessment, design and implement therapeutic interventions, exhibit advanced level clinical judgment skills, and hold conceptual and analytical skills. This will help me gain expertise in my chosen specialty field of ANP.
Incorporation of Social change Towards Professional Practice
I intend to contribute to my field of study by advocating for public health issues, such as social change, providing solutions to health disparities, and bringing justice to health services accessible to all. Here in the United States, despite living in the 21st century, we still fight against racial differences and socioeconomic limitations. Our health system policies need revision to cater to this public health issue, depriving the poor of quality health services.
References
American Association of Colleges of Nursing, & American Association of Colleges of Nursing. (2006). the essentials of doctoral education for advanced nursing practice.
Minnesota Department of Health. (2015, August). RHAC brief: Nurse practitioners in rural Minnesota-results of an employer . survey. https://www.health.state.mn.us/facilities/ruralhealth/rhac/docs/npbrief.pdf.
Walden University. (n.d.). Vision, mission and goals. https://catalog.waldenu.edu/content.php?catoid=147&navoid=47257
Wang, Y., Zhang, L., Tian, S., Wu, J., Lu, J., Wang, F., & Wang, Z. (2019). The relationship between work environment and career success among nurses with a master’s or doctoral degree: A national cross‐sectional study. International Journal of Nursing Practice, 25(4), e12743.
World Health Organization. (2013). Social determinants of health. http://www.who.int/social_determinants/en/
Readmission Prevention: Post-Discharge Calls and Follow-up Visits
An increasing burden on healthcare during the pandemic evokes discussions on reducing readmission rates. Some patients forget to visit their physicians timely, while others face numerous barriers regarding medication intake, doses, side effects, etc. As a result, they risk subsequent readmission, increasing the cost of treatment. Post-discharge calls and follow-up visits at a definite time after the initial visit may likely address the issue. I conducted a literature search to locate three scholarly sources to explore these prevention strategies. I accessed the PubMed database because it contains numerous peer-reviewed articles related to my topic of interest. I used such keywords as “readmission,” “prevention,” “discharge phone calls,” and “follow-up appointments.” Filters helped select only three relevant articles from more than ten research results, excluding non-original research, reviews, and sources published more than ten years ago. The selected scholarly articles provided preliminary findings on the value of discharge phone calls and follow-up appointments to reduce readmission rates.
First, Melton et al. (2012) focused on post-discharge phone calls to explore their effect on emergent readmissions of high-risk patients. They used a randomized control study research design, dividing participants (1994 in each group) into the intervention and control groups (Melton et al., 2012). The first one was contacted via phone within 24 hours, starting with patients with the highest risk; the second group received more delayed calls (48 hours without a call order) (Melton et al., 2012). The scholars found that the readmission rate 6o days after discharge was 7.4% for the intervention groups and 9.6% for the control group (Melton et al., 2012). While both calls may be efficient in ensuring transition care, earlier contacts (within 24 hours) were more valuable for lower readmission rates (Melton et al., 2012). Call order was also helpful, allowing scholars to reach high-risk patients timely and address their concerns (Melton et al., 2012). The article supports the value of post-discharge calls to patients to decrease readmission two months after their initial visits. The earlier nurses contact the individuals, the lower the risk of potential issues leading to the need for further clinic visits.
The second article by Coppa et al. (2021) researched the association between follow-up appointments after initial visits to physicians and readmission rates during a month. The scholars used a retrospective cohort study design, recruiting 50,772 individuals (Coppa et al., 2021). They found that 63.3% of the participants received calls to set appointments, and 36.8% were not contacted regarding follow-up visits (Coppa et al., 2021). The individuals who visited physicians during the week after the first visit after receiving notifications had a statistically lower readmission rate during a month than those unscheduled for a follow-up visit (Coppa et al., 2021). The readmission rate was the highest among those who received calls but did not arrive and patients without follow-up notifications (Coppa et al., 2021). The study supports the value of setting appointments during the first week after the discharge to reduce readmission rates.
The third article by Riverin et al. (2018) explored the most efficient timing of clinical visits after the first meeting with physicians among the elderly population. The scholars analyzed information regarding 620,656 admissions from 2002 to 2000 and affirmed lower readmission rates if patients arrived for their follow-up visits (Riverin et al., 2018). Yet, the most significant effect occurred when the individuals came seven-ten days after discharge (Riverin et al., 2018). A significant impact on lower admission rates was retained during the three weeks after the first visit and decreased after 21 days (Riverin et al., 2018). The study supports early follow-up visits and sets a limit of three weeks due to increased readmission without contact with physicians.
Finally, the three articles focus on different clinic prevention strategies, reaching a consensus on the significance of transitional care that can reduce the burden on healthcare. First, patients should be contacted regarding their feelings and condition after the first visit and recommended follow-up visits. Melton et al. (2012) and Coppa et al. (2021) show that patients are less likely to be readmitted to hospitals if the staff practice early discharge calls and set appointments via phones to remind them of subsequent visits. Additionally, readmission prevention strategies preserve their efficiency 30 days after discharge. Both studies revealed that calls and follow-up appointments decreased readmission rates during the first month after discharge (Melton et al., 2012; Coppa et al., 2021). Lastly, the time of calls and notifications in the transitional care affected the risk of readmissions. For example, Melton et al. (2012) showed lower rates when patients were contacted 24 hours after the first visit compared to 48 hours. Coppa et al. (2021) and Riverin et al. (2018) agreed on the value of early follow-up appointments seven days after discharge. Riverin et al. (2018) supplemented findings about follow-up visits, adding that in-person visits could reduce readmissions up to 21 days. The evidence suggests that patients may be notified about the value of additional weekly visits. These studies did not address visits 30, 60, and 90 days after discharge, justifying further research.
In conclusion, the analyzed studies provided preliminary findings on the value of phone calls and notifications to check patients’ conditions and set further appointments. The literature search shows a significant difference between the summary and synthesis of information. Thus, the first one provided the results of separate studies, allowing us to identify the significance of particular readmission prevention strategies. In the meantime, a synthesis helped single out similar themes, e.g., the value of early phone calls to check patients’ condition and to set appointments, the effect on readmission rates during 30 days, and the most appropriate time for the second visit (7-10 days to 21 days). The summary does not allow for identifying gaps. In contrast, a synthesis helped reveal a lack of clarity regarding follow-up visits 30, 60, and 90 days after discharge and the effect on readmissions. Thus, a summary of scholarly articles should lead to their synthesis to identify common and divergent themes and reveal gaps to justify further research.
