DNP- 802 PEER RESPONSES

DNP- 802 PEER RESPONSES

DNP- 802 PEER RESPONSES

DNP Peers’ Posts Needing Responses

I need help responding to the attached peers’ posts in 220 words each, kindly provide references with each post.

Instructions:

1. Make your initial post by 23:59 EST Thursday.

2. Respond to two other classmates’ posts by 23:59 EST Sunday. 

3. Address 2 of the following discussion questions in your post: 

1. Describe the evolution of the doctor of nursing practice curriculum and its potential impact on the future of nursing.  (CO1)

2. Analyze factors in our current healthcare delivery system that is driving the need for nurses prepared as at the doctoral level (CO1)

3. How do you determine the impact of the DNP degree?  What methods should be used to determine the impact of DNP  graduates? See pg 52 of Pritham & White article.  (CO1)

4. What are your thoughts on having a universal standard for APRN entry? 

Jace Sama

Analyze factors in our current healthcare delivery system that is driving the need for nurses prepared as at the doctoral level 

It is common for an individual to hear about the national nursing shortage on the news, or radio. This has become a growing topic since the development of COVID-19. One may also be familiar with the factor of nurse burnout. Schmidt (2020) informs that nearly 62% of nurses working in the United States are affected by some form of burnout. These two factors, including the use of advancing technologies in healthcare drive the need for nurses prepared at the doctoral level.

The doctoral prepared nurse is able to bridge the gap between theory and practice (Rivaz et al., 2021). Throughout this current doctor of nursing practice (DNP) program, students have been taught the ability to conduct research, review its validity and initiate it into practice. The DNP is the terminal degree which thoroughly prepares nurses to make change in the clinical setting. By utilizing the education provided by a DNP program, the nurse is able to understand how to provide effective change or adaptations for nurses affected by staffing shortages, or burnout. They may also be prepared to properly research advancing technologies (charting systems, tools, etc) and prepare nurses for their operation. The DNP prepared nurse displays top leadership, or management qualities based on their education. In times of stress or an ever changing environment, one may seek the expertise of the DNP prepared nurse for their guidance or leadership. Rivas et al. (2021) provide that challenging healthcare systems require nurse leaders that are able to manage unstable environments. This leader is the doctoral prepare nurse. 

What are your thoughts on having a universal standard for APRN entry?

According to McCauley et al. (2020), in 2004 the American Association of Colleges of Nursing (AACN) informed universities to transition to doctoral prepared advanced practice registered nurses (APRNs) programs by the year 2015. It is evident now that the AACN’s wish did not come true. This poses the question if there should be a universal standard for entry into APRN practice. A universal standard would allow equal clinical preparedness for practitioners. If the standard was changed to doctoral prepared nurses only, the education of the practitioner, excluding speciality education, would be similar to that of another APRN. However, one may question if it is wise to require an APRN to spend additional time and money on a degree with the current state of our healthcare system.

McCauley et al. (2020) inform that due to the increase in chronic health conditions and decline in resources, there has been a spike in the need for APRNs. The need for APRNs is crucial as illness and hospital admissions are increasing. This proposes that the APRN standard for entry into practice should remain as timely as possible. One may also argue that APRN candidates may not wish to pursue a doctoral degree or universal standard for entry. Within the last 10 years, doctoral nursing programs for the APRN have increased, however, there has been minimal decrease in the occurrence of master degree prepared APRN entry programs. If a universal standard is set, especially to the AACN’s standards, this may decrease the rate of APRNs into practice, thus minimizing the care provided to the public. This will provide additional strain to the already overwhelmed healthcare population. Although a universal standard for APRN entry seems ideal, the entry of a master degree or doctoral degree prepared APRN will suffice. 

References

McCauley, L., Broome, M., Fraizer, L., Hayes, R., Kurth, A., Musil, C., Norman, L., Rideout, K., & Villarruel, A. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track.  Nursing Outlook, 68(4). doi: 10.1016/j.outlook.2020.03.008

Rivaz, M., Shkorollahi, P., Setoodegan, E., & Sharif, F. (2021). Exploring the necessity of establishing a doctor of nursing practice program from experts’ views: A qualitative study.  BMC Medical Education, 21(328). doi: 10.1186/s12909-021-02758-w

Schmidt, A. (2020).  We need to talk about burnout the same way we talk about benefits. American Hospital Association. /orders/www.aha.org/news/blog/2020-10-20-we-need-talk-about-burnout-same-way-we-talk-about-benefits

Nadege Nnamani

The Doctor of Nursing Practice Degree: A Look at the Evolution and Potential Impact on Nursing

The Doctor of Nursing Practice (DNP) is a terminal degree in nursing that prepares nurses for advanced practice roles, such as primary care providers, consultants, and nursing leaders. The DNP curriculum typically includes advanced nursing practice, healthcare policy, leadership, and population health coursework. The DNP degree was developed in response to the growing demand for highly qualified nurses in advanced practice roles. The American Association of Colleges of Nursing (AACN) recognized the need for a practice-focused doctoral degree in nursing. It established the DNP as the terminal degree for advanced practice nursing in 2004 (The American Association of Colleges of Nursing (AACN), 2022). Prior to this, the highest degree in nursing was the Master of Science in Nursing (MSN), which was primarily focused on preparing nurses for research and academia (The American Association of Colleges of Nursing (AACN), 2022). The DNP curriculum has evolved to reflect the healthcare industry’s changing needs and the healthcare system’s increasing complexity (McCauley et al., 2020). The AACN has published guidelines for DNP programs, including coursework in healthcare policy, leadership, and population health, in addition to advanced nursing practice (McCauley et al., 2020). The potential impact of the DNP on the future of nursing is significant. As more nurses earn their DNP, they will be able to take on more advanced roles within the healthcare system and significantly impact patient care (American Association of Nurse Practitioners, 2022. The DNP degree also prepares nurses to be leaders in their field, which can help to shape the future direction of nursing and healthcare.

Factors Driving the Need for Nurses Prepared at the Doctoral Level

Several factors in the current healthcare delivery system drive the need for nurses prepared at the doctoral level. One factor is the increased complexity of healthcare. The healthcare system has become increasingly complex, with advanced technologies, specialized treatments, and complex patient cases (Hajizadeh et al., 2021). This has led to the need for highly trained nurses who can provide advanced levels of care and handle complex situations. Another factor is the shortage of primary care providers. There is a shortage of primary care providers in the United States, which has led to an increased demand for advanced practice nurses who can provide primary care services. The aging population also contributes to the need for nurses prepared at the doctoral level (Hajizadeh et al., 2021). As the population ages, there is an increased demand for healthcare services. Nurses prepared at the doctoral level can provide advanced care to older patients with complex health needs. The prevalence of chronic diseases, such as diabetes and hypertension, is also increasing. Nurses prepared at the doctoral level can provide advanced care and management for patients with chronic conditions. Finally, healthcare reform initiatives, such as the Affordable Care Act, have increased the focus on preventive and primary care services (Rivaz et al., 2021). Nurses prepared at the doctoral level can provide these types of care, which can help to reduce healthcare costs and improve patient outcomes.

Determining the Impact of the Doctor of Nursing Practice Degree

Several methods can be used to determine the impact of DNP graduates. One method is the use of outcome measures. This involves assessing the outcomes of DNP graduates’ practice, such as patient satisfaction, clinical outcomes, and cost savings. Surveys of DNP graduates and their employers can also provide valuable insights into the impact of the DNP degree (Pritham & White, 2016). These surveys can ask about the roles DNP graduates are taking on, their level of responsibility, and their impact on patient care and the healthcare system. Case studies of DNP graduates and their practices can provide a more in-depth understanding of the impact of the DNP degree. These case studies can look at specific projects or initiatives DNP graduates have undertaken and their impact on patient care and the healthcare system (Pritham & White, 2016). Data analysis can also be used to examine trends and patterns in the practice of DNP graduates over time. This could include analysis of administrative data, such as billing records, to assess the types of services DNP graduates are providing and their impact on healthcare utilization and costs. Finally, DNP graduates can contribute to the evidence base through peer-reviewed publications, which can help demonstrate the DNP degree’s impact on nursing practice and healthcare.

The Potential Benefits and Challenges of a Universal Standard for APRN Entry

Having a universal standard for APRN entry could have several benefits. One benefit is that it could increase the consistency and quality of care provided by APRNs (McCauley et al., 2020). A universal standard would ensure that all APRNs have met specific minimum requirements for education, training, and competency, which could improve patient safety and outcomes. Another benefit of a universal standard is that it could help to remove barriers to practice for APRNs. Currently, APRN practice is regulated by each state, and there can be significant variability in the requirements for APRN licensure and certification from one state to another (McCauley et al., 2020). A universal standard would provide a consistent set of requirements for APRN practice across the country, making it easier for APRNs to practice in multiple states and reduce patient care barriers. However, it is essential to consider that a universal standard would also require significant coordination and resources to implement. There would need to be agreement on the specific requirements for APRN practice and a mechanism for enforcing the standard. There could also be challenges in addressing the unique needs and circumstances of different states and regions.

References

The American Association of Colleges of Nursing (AACN). (2022).  DNP position statement. /orders/www.aacnnursing.org/DNP/Position-Statement

The American Association of Colleges of Nursing (AACN). (2022).  AACN fact sheet – DNP. /orders/www.aacnnursing.org/News-Information/Fact-Sheets/DNP-Fact-Sheet

American Association of Nurse Practitioners. (2022).  Discussion paper: Doctor of nursing practice. /orders/www.aanp.org/advocacy/advocacy-resource/position-statements/discussion-paper-doctor-of-nursing-practice

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: A systematic review.  BMC Nursing,  20(1). /orders/doi.org/10.1186/s12912-021-00648-6

McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M., Norman, L. D., Rideout, K. H., & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track.  Nursing Outlook,  68(4), 494–503. /orders/doi.org/10.1016/j.outlook.2020.03.008

Pritham, U. A., & White, P. (2016). Assessing DNP impact using program evaluations to capture healthcare system change.  The Nurse Practitioner,  41(4), 44–53. /orders/doi.org/10.1097/01.npr.0000481509.24736.c8

Rivaz, M., Shokrollahi, P., Setoodegan, E., & Sharif, F. (2021). Exploring the necessity of establishing a doctor of nursing practice program from experts’ views: A qualitative study.  BMC Medical Education,  21(1). /orders/doi.org/10.1186/s12909-021-02758-w

Brandi Ritchie

2. Analyze factors in our current healthcare delivery system that is driving the need for nurses prepared at the doctoral level

We live in complicated times. Healthcare is at a precipice where change must occur if we are to survive. Healthcare will never “die out” or fade away, but healthcare as we currently know it isn’t sustainable. I believe most of us at least toyed with this idea before the pandemic, but COVID has highlighted many of the cracks within the healthcare system and nursing specifically. Nurses are being asked to do more than ever, and not just at the bedside. Over the course of my career I have seen nursing leadership evolve to a place where an entry level bedside nursing degree is no longer sufficient. 

The American Association of Colleges of Nursing (AACN) (2006) reports one of the benefits of doctoral preparation in nursing as being enhanced leadership that fosters strengthened practice and healthcare delivery. Historically nurses have risen to power primarily based on tenure and tenacity. There is no academic preparation at the bachelor (BSN) level or below for a nursing leadership position. It has been my experience that my bachelors degree prepared me to be a clinically competent bedside nurse who could evaluate evidence as it relates to practice at a very basic level. My masters (MSN) degree in nursing executive leadership scratched the surface of the knowledge necessary to lead nursing in today’s healthcare systems and greatly enhanced my ability to translate knowledge into practice. However, I am pursuing my Doctorate of Nursing Practice (DNP) because I know that there is more to be learned before I am truly prepared to tackle an executive leadership role. Through experience and observation it has never been more clear to me that our nursing leaders must be better prepared to fully expand into their roles. The pandemic has acted as a highlighter to the issues of inadequate nursing leadership. An excellent clinical bedside nurse does not always make a great leader and a well educated nurse does not always have what it takes either. My hope for the future of nursing is that the DNP can provide a foundation on which nurse leaders can build more sustainable nursing environments that, undoubtedly, will lead to better patient and nurse outcomes.   

4. What are your thoughts on having a universal standard for APRN entry?

I very distinctly remember hearing about the push to DNP prepared advanced practice registered nurses (APRN) early in my career. My initial thought was something along the lines of “that is ludicrous.” Now, 18 years into my nursing career and 2 years living in a pandemic my thoughts are far more complex. Early in the pandemic I transitioned into a clinical education role and left the bedside. I moved from a large teaching institution that held Magnet nursing status to a much smaller hospital where a majority of the bedside nurses were educated at the associate’s degree (ADN) level. It was a jarring shift in organizational priorities for me to observe. My ADN nurses provide excellent clinical care and I couldn’t differentiate between those with a BSN or ADN on any given day. It was simply very different from the push for BSN and higher education at my previous organization. As the pandemic worsened and nursing saw mass exits into travel assignments or out of the profession altogether, the already invisible line between ADN, BSN, even MSN prepared nurses completely vanished. I saw a resurgence in the hiring of licensed practical nurses. Numerous nurse researchers and nursing organizations have long said that there is a need to better define the clinical proficiencies between nursing degrees (McCauley et al., 2020; Boswell et al., 2021). My experience has made that need very apparent to me. Nursing has fought for autonomy and gained it in many rights, but without role clarification based on education I fear we have come as far as we can. 

One glaring example of the need for clarification lies within my field of interest, perinatal services. Fullerton et al. (2019) pinpointed some key issues to consider regarding the DNP as the preferred degree for entry to practice amongst midwives. Currently, there are certified nurse midwives who are educated in both nursing and midwifery and certified midwives who lack the nursing education component that are able to obtain the same midwife certification and practice at the same level (Fullerton et al., 2019). The American College of Nurse Midwives (ACNM) is of the opinion that DNP is an option for the practice of midwifery, but should not be required for entry into the field due to a lack of data that suggests that practice quality is improved by the DNP degree (Fullerton et al., 2019). While I wholeheartedly believe that there is a need and a place for the DNP prepared nurse, I’m not entirely convinced that it is necessary for entry into advanced clinical practice. Boswell et al. (2021) looked at the impact of the DNP degree in their geographical area and found both benefits and challenges. DNP prepared nurses displayed improved communication, leadership and influence (Boswell et al., 2021). Unfortunately, they also noted a lack of understanding regarding the role and a lack of recognition for the rigor of their education (Boswell et al., 2021). What can we do to help normalize DNP recognition amongst our peers and colleagues? What is the best and most efficient way to inform others about the benefits of a DNP prepared nurse? If the APRN remains at the clinical level, treating patients, is it imperative that they obtain a DNP?

References

American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for Advanced Nursing Practice. Author.

Boswell, C., Mintz-Binder, R., Batcheller, J., Allen, P., & Baker, K. A. (2021). Capturing the impact of the doctor of nursing practice degree on west texas health care.  The Journal of Continuing Education in Nursing,  52(4), 192–197. /orders/doi.org/10.3928/00220124-20210315-08

Fullerton, J. T., Schuiling, K. D., & Sipe, T. A. (2019). The Doctorate of Nursing Practice and entry into midwifery practice: Issues for consideration and debate.  Nurse Education in Practice,  36, 97–100. /orders/doi.org/10.1016/j.nepr.2019.02.001

McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M., Norman, L. D., Rideout, K. H., & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track.  Nursing Outlook,  68(4), 494–503. /orders/doi.org/10.1016/j.outlook.2020.03.008

Cassidy Fox ( He/Him)

               The push to require a Doctor of Nursing Practice (DNP) degree as the entry-level to practice as a nurse practitioner has been the subject in the medical community for many years. Similar to the drive for registered nurse programs to become a BSN entry-level and to phase out the two-year associate program, there has also been a push to suspend the Master of Science in Nursing (MSN) nurse practitioner program and make the DNP the entry-level for nurse practitioners. The American Association of Colleges of Nursing first pushed for the phase-out of Advanced Practice Registered Nurses (APRN) MSN programs in 2004 and wanted all MSN programs to be transitioned to DNP programs by 2015 (McCauley et al., 2020). Although the 2015 deadline was not met, many organizations are still pushing for the transition to the DNP as the entry-level. Furthermore, the National Organization for Nurse Practitioner Faculties pledged to transition to a DNP entry-level education for all nurse practitioners by 2025 (Idzik et al., 2021). The organizations proposing the shift to the entry-level degree often detail the everchanging role and requirement of the nurse practitioner and suggest that obtaining a DNP would help better prepare the nurse practitioners for these roles. The aging population is often referenced as one of the driving forces behind the proposal for changing the degree requirements. The idea is that the DNP program will help prepare students for the complex needs of patients and the evolving healthcare environment (Idzik et al., 2021).

              The push for higher education in healthcare is always a great goal in theory, but I fear that this is in direct conflict with the national shortage in nursing concerning registered nurses. Approximately, 275,000 additional nurses will be needed by 2030 to meet the needs of the aging population according to the Bureau of Labor Statistics (Haddad et al., 2022). Registered nurses can complete a program in two years and begin working after the two-year program. The transition to a four-year program would increase the time spent in school and place a strain on the already critical nursing shortage in the United States. The barriers in rural healthcare areas are often a challenge for registered nurses to obtain advanced degrees including distance to programs and lack of financial support from employers (Odahowski et al., 2021).  Although I do not fully agree with the push for the BSN degree as the entry-level for registered nurses, I could more easily adopt the idea of the DNP being the entry-level degree requirement for APRNs.

              In my practice region, the market is inundated with nurse practitioners and nurse practitioner students. Students often have to pay for their clinical rotations so they can secure a site and new nurse practitioners find it difficult to secure a job. I do not feel as though the requirement for the entry-level DNP for APRN practice will have the same impact that the BSN requirement for registered nurses will have on the field of nursing in this area. I do believe that this DNP requirement may make the APRN role less desirable. There are not any current studies, that could be found, regarding the view potential students have regarding the switch from MSN entry-level to a DNP entry-level APRN. The research should focus on the perceptions of potential nurse practitioner students and how this may affect the enrollment of new students into APRN programs.

              Although some areas are inundated with nurse practitioners, some areas have a great need for advanced practice providers. An example of an area with great need is the rural healthcare market. Rural healthcare facilities and primary care practices in rural America continue to have shortages of providers and the academic transition could place greater strain on these regions (Ortiz et al., 2018). One example of an area flooded with students is the Philadelphia, Pennsylvania region. In the Philadelphia area, there are 6 medical schools and 10 nurse practitioner schools that create a strain on the pool of preceptors which makes it difficult for student placement (Todd et al., 2019). Extensive research would need to be completed to fully understand the future healthcare needs and the impact of switching to the DNP as the entry-level for APRNs. First, it is important to understand the future growth of the healthcare field in the next 10 to 20 years and how many nurse practitioner roles will be needed. Additionally, the impact on the future nursing interest in the APRN role should be evaluated regarding the impact of requiring a DNP.

             I would also propose the importance of clear research associating improved patient outcomes with DNP-prepared nurse practitioners. The Institute of Medicine proposed that 80% of working nurses should obtain a BSN by 2020 due to reports of improved patient outcomes in hospitals with a higher proportion of BSN-prepared nurses (Harrison et al., 2019). One study found that hospitals with higher percentages of BSN-prepared nurses along with lower nurse-to-patient ratios were associated with improved patient outcomes after cardiac arrest (Harrison et al., 2019). The push for BSN-prepared nurses is supported by studies that have shown a correlation with improved patient outcomes. The research is quite limited when searching for patient outcomes comparing MSN-prepared nurse practitioners and DNP-prepared nurse practitioners. It is important to understand the impact of the DNP degree and how to measure those impacts. The change is more likely to be accepted when it is supported by improved patient outcomes. One critical area to study is patient outcomes and if the DNP degree has a positive impact, a negative impact, or an overall neutral impact on the outcomes of patients.  

            The impact of the DNP degree is an important area of focus when considering the push to require this degree. It is important to consider how to evaluate the outcomes of the DNP degree and how it affects the delivery of healthcare, the health of individuals, and the overall care of patients (Pritham & White, 2016). We should consider if the requirement of the DNP entry-level for an APRN would negatively or positively impact the care of patients and the delivery of healthcare. It is critical to gauge all the potential outcomes from a transition to the DNP degree as the entry-level for the APRN. Could the requirement negatively impact the access to healthcare for the public? Would this reduce interest in the APRN field as a whole? The overall costs of the programs should also be taken into consideration. The overall benefits of the transition should outweigh the potential detractors. One potential evaluation technique would be to complete outcome studies to better gauge patient-based outcomes (Pritham & White, 2016). If there is a correlation regarding improved patient outcomes when comparing MSN to DNP graduates then this could be the push needed for the transition an entry-level DNP for the APRN role.

            Another consideration is the delivery of healthcare and how it is affected by the proposal. The nurse practitioner role has been able to assist in reducing the healthcare strain in primary care that has been caused by an aging population and high prevalence of chronic health conditions in the United States (Poghosyan et al, 2021). A thorough evaluation would need to be completed regarding the impact this may have on the long-term impact on the APRN field. In the extended outlook, could this reduce the enrollment and graduation of APRNs? The overall strain on healthcare could be detrimental if this reduced the number of registered nurses who return to school for their APRN. Many colleges detail the growing need for advanced practice providers as well as financial constraints as reasons they have not yet transitioned to solely DNP-level programs for APRNs (Martsolf et al., 2015). The current interests and discussions regarding a universal standard will help to drive the necessary research to better understand and gauge the impact this will have on the healthcare field.

References

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing shortage. In  StatPearls. StatPearls Publishing.

Harrison, J. M., Aiken, L. H., Sloane, D. M., Brooks Carthon, J. M., Merchant, R. M., Berg, R. A., McHugh, M. D., & American Heart Association’s Get With the Guidelines–Resuscitation Investigators (2019). In hospitals with more nurses who have baccalaureate degrees, better outcomes for patients after cardiac arrest.  Health affairs (Project Hope),  38(7), 1087–1094. /orders/doi.org/10.1377/hlthaff.2018.05064

Idzik, S., Buchholz, S. W., Kelly-Weeder, S., Finnegan, L., & Bigley, M. B. (2021). Strategies to move entry-level nurse practitioner education to the doctor of nursing practice degree by 2025.  Nurse educator,  46(6), 336–341. /orders/doi.org/10.1097/NNE.0000000000001129

Martsolf, G. R., Auerbach, D. I., Spetz, J., Pearson, M. L., & Muchow, A. N. (2015). Doctor of nursing practice by 2015: An examination of nursing schools’ decisions to offer a doctor of nursing practice degree.  Nursing outlook,  63(2), 219–226. /orders/doi.org/10.1016/j.outlook.2015.01.002

McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M., Norman, L. D., Rideout, K. H., & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track.  Nursing outlook,  68(4), 494–503. /orders/doi.org/10.1016/j.outlook.2020.03.008

Odahowski, C. L., Crouch, E. L., Zahnd, W. E., Probst, J. C., McKinney, S. H., & Abshire, D. A. (2021). Rural-urban differences in educational attainment among registered nurses: Implications for achieving an 80% BSN workforce.  Journal of professional nursing, 37(2), 404–410. /orders/doi.org/10.1016/j.profnurs.2020.04.008

Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes.  Healthcare,  6(2), 65. /orders/doi.org/10.3390/healthcare6020065

Poghosyan, L., Norful, A. A., & Martsolf, G. R. (2017). Primary care nurse practitioner practice characteristics: Barriers and opportunities for interprofessional teamwork.  The Journal of ambulatory care management,  40(1), 77–86. /orders/doi.org/10.1097/JAC.0000000000000156

Pritham, U. A., & White, P. (2016). Assessing DNP impact using program evaluations to capture healthcare system change.  The Nurse practitioner,  41(4), 44–53. /orders/doi.org/10.1097/01.NPR.0000481509.24736.c8

Todd, B. A., Brom, H., Blunt, E., Dillon, P., Doherty, C., Drayton-Brooks, S., Hung, I., Montgomery, K., Peoples, L., Powell, M., Vanacore, D., Whalen, D., & Aiken, L. (2019). Precepting nurse practitioner students in the graduate nurse education demonstration: A cross-sectional analysis of the preceptor experience.  Journal of the American Association of Nurse Practitioners,  31(11), 648–656. /orders/doi.org/10.1097/JXX.0000000000000301

DNP-810A Peers’ Posts Needing Responses

Abiodun Kolawole

Posted Date

The news story chosen for analysis is entitled “Dwarfism drug aims to boost healthy growth.” According to the article, achondroplasia is one of the most common types of dwarfism, which affects one individual in every 25,000 people (Roberts, 2019). Achondroplasia is a genetic disorder caused by the mutation of a gene that limits the growth of bones in the skull base, the limbs, and the spine (Pauli, 2019). The author describes the typical case of an achondroplasia-affected child named Sam with short legs and arms. However, researchers have developed a new type of medication known as vosoritide that promotes healthy growth among children born with dwarfism. The drug’s effectiveness can be proven by comparing the growth of Sam before and after the injection before he joined the study. Sam grew 3cm (1in) after the injection and another 6cm in the first year after treatment (Roberts, 2019). In terms of ethics, RNs or APRNs are concerned about whether the drug can prevent growth-related complications. In terms of societal implications, the approval of the medication would change dwarfism. However, there is still uncertainty about whether individuals with the disorder would support the intervention. Because vosoritide has not yet gained FDA approval, RNs and APRNs cannot prescribe the drug to their patients at this time. Culture can influence how disability is understood and how individuals with disabilities are treated. As a result of media narratives that inaccurately portray disability, societal beliefs become dominant (Haller, 2010). However, the effect of these beliefs on dwarfs in the community has been largely ignored. Dwarfs are often subjected to unwanted attention due to their appearance, including staring and verbal abuse, which can be considered a social disability.

References

Haller, B.A. (2010) Representing Disability in an Abelist World. Louisville: The Avocado Press.

Roberts, M. (2019). Dwarfism drug aims to boost healthy growth. Retrieved May 12, 2022, from /orders/www.ncbi.nlm.nih.gov/search/research-news/3265/

Pauli RM. Achondroplasia: a comprehensive clinical review. Orphanet J Rare Dis. 2019 Jan 3;14(1):1. /orders/ doi.org/ 10.1186/s13023-018-0972-6.

Solomon, S. (2020) Dwarf Pride’ Was Hard Won. Will a Growth Drug Undermine It. Retrieved May 12, 2022, from /orders/www.ncbi.nlm.nih.gov/search/research-news/11271/

Kristen Williams

Ribonucleic acid (RNA) plays an essential role in messenger Ribonucleic acid (mRNA) translating and decoding (D’Ascenzo et al., 2022). Advancements in technology have improved scientists’ ability to sequence RNA leading to the development of medication and targeted therapies. Advances in RNA sequences have led to biotech companies’ billions in investments (Wang et al., 2020). The potential impact on the pharmaceutical industry from targeted drug development is massive and has the potential to save millions of lives. Although the potential to save lives is vast many ethical, fiscal, and social issues arise. Many uncertainness surrounds the role of genomics in the prognosis and management of diseases (Newson et al., 2016). 

The advancements in RNA have led to more advanced medication development. Although improvements are taking place in the effect of medications, access continues to be a problem. Prescription medicines are not assessable to many due to financial causes. Social and ethical dilemmas currently reside around increasing access to medication as this technology advances. As billions are poured into developing new medicines and treatments, society needs to ensure they are accessible to those who need them. For developing technology to be accessible, a shift must occur in our culture surrounding healthcare. Currently, access to healthcare is a privilege and not a right. There is potential that as technology advances, a cultural shift will occur, and healthcare will be viewed as a right and expanded to those in need. 

References

D’Ascenzo, L., Popova, A. M., Abernathy, S., Sheng, K., Limbach, P. A., & Williamson, J. R. (2022). Pytheas: A software package for the automated analysis of RNA sequences and modifications via tandem mass spectrometry. Nature Communications, 13(1).  /orders/doi.org/10.1038/s41467-022-30057-5

Newson, A. J., Leonard, S. J., Hall, A., & Gaff, C. L. (2016). Known unknowns: Building an ethics of uncertainty into genomic medicine. BMC Medical Genomics, 9(1).  /orders/doi.org/10.1186/s12920-016-0219-0

Wang, F., Zuroske, T., & Watts, J. K. (2020). Rna therapeutics on the rise. Nature Reviews Drug Discovery, 19(7), 441–442.  /orders/doi.org/10.1038/d41573-020-00078-0

Yu, A.-M., Choi, Y., & Tu, M.-J. (2020). Rna drugs and RNA targets for small molecules: Principles, progress, and challenges. Pharmacological Reviews, 72(4), 862–898.  /orders/doi.org/10.1124/pr.120.019554

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – DNP- 802 PEER RESPONSES

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score. DNP- 802 PEER RESPONSES

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

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