SWOT Analysis

 DNP ROLE SWOT and PEST ANALYSIS

It is becoming increasingly clear that clinics would benefit from being led by a Director of Nursing (DON)  with a Doctor of Nursing Practice (DNP) degree due to the experience they bring to the table . The DON is the person in charge of overseeing and implementing changes to nursing staff ranging from shift changes, infection control, prevention procedures, evaluating and directing the staff while establishing goals and creating and making sure everyone is compliant with the healthcare policies in place.  To fill the gap between clinical practice and healthcare research and to provide leadership and direction to nursing personnel in the clinic setting, this position was selected for its advanced practice nurse qualifications.

According to Pritham and White (2016), a DNP-prepared nurse would be able to understand how to handle ethical dilemmas because of the advanced technologies and scientific findings that are rapidly occurring within the field. They would also be able to participate in ethics reviews and policy-making committees, which would benefit everyone involved.

While reviewing our weekly readings from the American Association of Colleges of Nursing (AACN, 2006), the Essentials also made it very clear how the DNP program equips the DNP-prepared nurse ranging from Essentials 1 through 8 just to name a few. They are equipped with knowledge ranging from how to bring about changes in the healthcare status, organizational and systems leadership for quality improvement which affects healthcare and patient outcomes, scholarship, and research by the form of discovery, they also advocate for good healthcare policies and able to collaborate inter-professionally and also promote health which is listed under Essential VII (AACN, 2006). All these are the qualifications and tools that a DNP-prepared DON would bring to the table within the clinic with the end goals of achieving a great team and great patient outcomes.

There was also an analysis done by the AACN which showed a time frame of seven years and how fast people that were already registered nurses were obtaining their doctorate degree with a concentration in DNP instead of the Ph.D. (AACN, 2006). This goes to show how important the DNP-prepared nurse is and its place within society continues to grow rapidly.

There is a void in the research on this topic because most studies have concentrated on the function of the DNP-prepared nurse in hospitals and other tertiary care facilities rather than primary care settings like clinics (Zaccagnini & Pechacek, 2021). The advanced knowledge and skills required to lead the implementation of evidence-based practice and improve the quality of care provided to patients are uniquely suited to the DNP-prepared nurse. The DNP-prepared nurse is increasingly being recognized as the ideal candidate for this position in clinical settings due to the fact that almost everything required for this position has to be evident based in order to be successful.

Educators with a Master of Science in Nursing (MSN) degree can learn much from the DNP perspective, which differs in various ways from MSN. First, a DNP graduate with advanced education in healthcare research and the ability to critically analyze and apply research findings to clinical practice is in a better position to lead the implementation of evidence-based practice in the clinic. The DNP holder has a deeper understanding of healthcare systems and interdisciplinary team dynamics, making them better equipped to provide leadership and direction to their nursing staff (Trautman et al., 2018).

The DNP DON will be equipped with superior expertise in healthcare research, data analysis, and quality improvement, allowing them to pioneer the introduction of evidence-based practice in clinical settings. They will also have superior management and leadership abilities, allowing them to steer the nursing team in the right direction and collaborate fruitfully with other medical professionals (Zaccagnini & Pechacek, 2021). The Doctor of Nursing Practice (DNP) holder will also be equipped with the knowledge and skills necessary to effectively advocate for patients and enhance the quality of care delivered in clinical settings by virtue of their familiarity with and mastery of healthcare systems. The DON holds a DNP degree and is dedicated and understands the importance of using evidence-based practice as a tool to achieve their goals within the clinic and lead the staff in the direction required to achieve evidenced based outcomes. In this paper, we will discuss the SWOT(strength, weakness, opportunities, and threats) analysis for a DNP-prepared DON in clinics that apply evidenced based practice in their services.

 

SWOT Analysis

Strengths ·         Advanced education and training in evidence-based practice, leadership, and quality improvement- Doctor of Nursing Practice (DNP) programs prepare nurses to critically evaluate and apply research to clinical practice, giving them the skills to make informed decisions and improve patient outcomes. ·         Leadership capabilities: As a DNP-prepared nurse, the DON has the knowledge and skills to effectively lead and manage a clinic (Trautman et al., 2018). ·         DNP graduates are prepared to design, influence, and implement health care policies that frame health care financing, practice regulation, access, safety, quality, and efficacy(AACN, 2006). ·         DNP-prepared NPs strongly understand healthcare systems and can analyze and use data to improve patient outcomes. This allows them to take a leadership role in improving primary care delivery and to advocate for policy changes that support and improve patient-centered care characterized by quality services (Zaccagnini & Pechacek, 2021). ·         They have the ability to incorporate most if not all of the essentials learned during the DNP education (AACN, 2006) ·         Strong research skills: DNP-prepared nurses have strong research skills that will be utilized to eradicate the low quality of care provided in the clinic(AACN, 2006).

Weaknesses ·         Limited understanding of business aspects: While DNPs have advanced healthcare knowledge, they may not have formal business management and administration training. ·         The limited scope of practice: In some states, DNPs may have a different scope of practice than physicians, limiting their ability to make certain clinical decisions. ·         Limited reimbursement: Some insurance plans may only partially reimburse for services provided by advanced practice nurses, which can limit their ability to provide care. ·         Limited access to certain medications: DNP-prepared nurses may not have the same prescribing authority as physicians, which can limit the care that can be provided (Zaccagnini & Pechacek, 2021). ·         Limited public recognition: DNP-prepared nurses may not be as well-known as physicians, which can limit the recognition of their skills and expertise and utilization. ·         Limited access to certain medical equipment: DNP-prepared nurses may not have the same access to medical equipment as physicians, which can limit the care that can be provided to the community. ·         Difficult change culture without strong administrative support can be an issue also (AACN, 2006)

Opportunities ·         Increased demand for advanced practice nurses: As the healthcare system shifts towards value-based care, there is a growing need for advanced practice nurses like DNPs to provide high-quality, cost-effective care(Pritham & White, 2016). ·         Collaboration with other healthcare professionals: The DON, as a DNP, can collaborate with physicians, pharmacists, and other healthcare professionals to improve patient outcomes and decrease healthcare costs. ·         Telehealth: The increasing use of telehealth can allow DNP-prepared nurses to care for patients in remote areas which would improve patient’s ability to access care without thinking about issues with transportation(Moran et al., 2020). ·         Increased use of technology: DNP-prepared nurses can use technology to improve the quality and efficiency of care provided in the clinic. ·         Increased focus on preventive care: DNP-prepared nurses can use their knowledge and skills to promote preventive care in the clinic (Zaccagnini & Pechacek, 2021). ·         Increased focus on community health: DNP-prepared DON can use their skills to improve the community’s health by providing education and outreach as a team to the community.

Threats ·         Limited reimbursement for advanced practice nurses: Some insurance plans may not fully reimburse for services provided by advanced practice nurses, which can limit their ability to provide care. ·         Resistance to change: Some healthcare professionals may be resistant to the integration of advanced practice nurses into the healthcare system and may not fully understand or support the role of the DNP(. ·         Limited funding for advanced practice nurses: There may be limited funding for advanced practice nurses, which can limit the services that can be provided. ·         Some states may continue to have a restrictive scope of practice laws for NPs, which could limit the ability of DNP-prepared NPs to practice to the full extent of their education and training” (AACN, 2006). ·         Limited access to certain medications or equipment: DNP-prepared nurses may not have the same prescribing authority as physicians, which can limit the care that can be provided (Zaccagnini & Pechacek, 2021). ·         Limited public recognition: DNP-prepared nurses may not be as well-known as physicians, which can limit the recognition of their skills and expertise in the healthcare system and may also affect the clinic’s reputation in the community. ·         The DNP’s function as an NP in primary care is significantly influenced by political and economic factors, such as legislation and regulations that govern the scope of practice and reimbursement for services. Threats to the job include the COVID-19 pandemic and the fate of the Affordable Care Act (HRSA, n.d).

 

 

PEST Analysis Part two

Political influences:

The political environment significantly impacts the DNP’s role as a Nurse Practitioner (NP) in primary care. Laws and regulations regarding DNP practice vary from state to state, and some states have more restrictive scope of practice laws for NPs. Several studies carried out in other countries such as the United States, Ghana, and Portugal suggest limited political inclusion, with Nursing professionals’ political activity restricted to voting and making contact with legislators about the demands of interest for the category, recognizing that there is a need for a broader involvement to cause changes in laws and regulations that limit professional performance. (Mourão Netto et al., 2022, p.3).

The core competencies for healthcare policy for advocacy in healthcare are embedded in DNP Essential V, but competencies from many of the DNP Essentials are also applicable. For example, healthcare professionals need to be able to advocate for people that are poor while urging lawmakers to change the current system. Essentials V to VII indicates the role of a  DNP-prepared nurse advocating for social justice, equity, and ethical policies within all healthcare arenas (AACN, 2006 as cited in Moran et al., 2020 p.74). Being able to advocate helps with improvement In advocacy and lobbying efforts to raise awareness of the value that DNP-prepared nurses can bring to patient care and the healthcare system. This can involve meeting with policymakers, healthcare leaders, and other stakeholders to educate them about the DNP role and to promote the benefits of DNP-led care.

Evidence from numerous studies supports that leadership and innovation are critical factors for organizational success and improved outcomes. Further, no change takes place and sustains without strong leadership (Melynk & Raderstorf, 2019, p.200).

There are some states with limitations and restrictive scope of practice laws, DNPs may not be able to prescribe certain medications or perform certain procedures without physician oversight however if a DNP-prepared DON is involved with the process of decision making this can reduce if not eradicate the issue of limitation since they can vote and participate in making these changes (Trautman et al., 2018). For example, some states require DNPs to have a collaborative agreement with a physician to practice in any capacity. This can limit the ability of DNPs to provide care in certain settings, such as rural or underserved areas where there is a shortage of physicians. Additionally, the political environment can also affect reimbursement for DNP services. These professionals can use their influence to actively participate in electoral campaigns and in the process of formulating public policies because, by having their professional knowledge and skills available, they cannot only benefit users and contribute to public health, but also ease the development of nursing as a science and professional field (Mourão Netto et al., 2022, p.7)

Economic influences:

The current economic climate significantly influences the function of a DON with a DNP degree in primary care. There is a rising need for affordable healthcare as the rising expense of healthcare becomes a key issue for many Americans.  A DNP-educated DON would be able to make wise resource allocation decisions and assist in providing leadership in a positive direction. As a result, DNP-prepared DON is able to play a more significant role in primary care, which can help curb the demand for more costly specialized services (Larocco, 2021).  Furthermore, DONs with a DNP degree have the expertise to address the socioeconomic determinants of health and to plan and implement interventions that improve population health and reduce the prevalence of all types of disease.

However, paying for DNP services is sometimes difficult and making patients’ access to care constrained, and DNP-led clinics’ financial stability might be jeopardized by the fact that some insurance plans do not cover services delivered by DNPs (Trautman et al., 2018). This can be a problem for both the patients whose insurance doesn’t cover NP services and the NPs who deliver them. The ability of a DNP DON to deliver care and services may also be constrained by states with a restricted scope of practice rules which would lead to incurring more expenses as a result of time and gas spent getting to and from medical appointments.

Social influences:

The social determinants of health include genetic as well as lifestyle and environmental factors, such as the availability of resources to meet daily needs such as housing, food markets, job opportunities, access to health services, and education. These factors have a huge impact on the health of our nation (Moran et al., 2020, p.74). Due to the fact that a DNP-prepared DON has the ability to link data at an individual level with administrative data to assess how social determinants interact with the healthcare system utilizing the competencies they have acquired from Essentials#4 which is to be able to analyze data, within the healthcare information and patient care technology systems, then informs key stakeholders what critical elements are necessary to the selection, use, and evaluation of this information (AACN, 2006).

In primary care, the DNP Nurse practitioner’s role is significantly influenced by the surrounding social milieu, particularly in impoverished and rural areas where primary care doctors are in high demand. This need is being fueled by demographic shifts, including an aging population and an uptick in the prevalence of chronic illnesses. Not all patients are familiar with doctorate degree NPs or comprehend the breadth of their responsibilities (Zaccagnini & Pechacek, 2021). Because of this misunderstanding, patients may be confused or distrustful of them, making it hard for them to build a clientele. It’s also important to note that not everyone regards doctorate-degree NPs as primary care doctors. Because of this stigma, they may have trouble establishing collaborative partnerships with other medical professionals and being able to lead a clinic.

In addition, there may be misconceptions about doctorate degree nurse practitioners (NPs) among the general public. Despite popular belief, research shows that such nurse practitioners (NPs) deliver treatment that is on par with that of physicians in terms of quality and safety. Still, these ideas may have an impact on how patients and other medical professionals receive them.

Healthcare policy and laws are influenced by both the political and social contexts in which they are enacted. A Doctor of Nursing Practice (DNP) in primary care may be impacted by changes in healthcare policy and legislation pertaining to reimbursement for DNP services, the scope of practice laws, and certification prerequisites. DNPs-prepared DONs can participate in professional networking opportunities, such as conferences, webinars, and online communities, to build relationships and collaborate with other healthcare professionals. This can help to promote the DNP role and to share best practices and information about the impact of DNP-led care on patient outcomes. That’s why it’s crucial to know the latest developments in healthcare laws and policy and to push for measures that recognize and reward their contributions to primary care.

Technological influences:

The primary care NP position held by those with DNP-prepared nurses is profoundly affected by the current state of technology. New diagnostic and therapeutic options, made possible by technological progress, have the potential to enhance health outcomes for patients. In rural or underserved locations, for instance, DNPs can now employ telehealth technologies to treat patients remotely, confer with specialists, and access patient medical information. Access to care that might otherwise be unavailable can greatly enhance patient outcomes in these situations. In addition, DNPs are now able to treat patients in underserved and rural areas thanks to the widespread adoption of electronic health records (EHRs). Doctorate-degree DON’s can benefit from electronic health records (EHRs) because it gives them access to patients’ past medical history, financial records, past and current test results, and other relevant data that can be used to better care for these patients (Trautman et al., 2018).

In addition, they facilitate enhanced physician-to-physician contact and care coordination, both of which contribute to enhanced patient outcomes. Although there are many benefits to using technology, there are also risks that DNPs must consider. In this regard, the adoption of electronic health records (EHRs) can be both time-consuming and cumbersome for DNP-led clinics. This makes it harder for them to spend quality time with patients and can contribute to burnout. Concerns concerning patients’ privacy and security may also arise from the usage of telehealth devices. This raises concerns because the current state of development prevents assurance of the same level of privacy and security as face-to-face meetings. Patients with less access to technology or less technical expertise may be at a disadvantage while seeking medical care because of the increased reliance on technology. This can be especially difficult for DNPs in rural or underdeveloped areas, where there may be fewer resources, such as computers. In addition, DNPs may face difficulties due to the quickening pace of technical developments, which requires them to upgrade their knowledge and skills constantly. This calls for further study and instruction, which takes time and effort. When reviewing evidence, a DNP-prepared nurses are able to analyze scientific data related to individual, aggregate, and population health (Essential 7) and critically review any existing literature and other evidence to be able to identify the best evidence and implement them  (Essential 3)(AACN, 2006)

Implementation Strategies

The implementation of the new role of DNP-prepared NPs in primary care requires a comprehensive approach that addresses stakeholder support, funding and costs, a theoretical framework, and evaluation methods. This will ensure the success of the role and its sustainability in the long term. To be able to facilitate the Implementation of the new role of DNP-prepared DON in primary care one must focus on obtaining stakeholder support and addressing potential funding and cost concerns that could arise as issues towards the goals required. Evidence from numerous studies supports that leadership and innovation are critical factors for organizational success and improved results and also no change can take place and be sustained without strong leadership. (Melynk & Raderstorf, 2019, p.200).

Stakeholder Support:

To gain stakeholder support for the new role, it is important to educate stakeholders about the benefits of having a DNP-prepared DON in primary care and to demonstrate the cost-effectiveness of the role. This can be done through the use of data and research studies, as well as through the development of strong relationships with key stakeholders such as physicians, healthcare administrators, and policymakers.   In today’s value-driven healthcare industry, being able to answer all questions that the stakeholders may have would be valuable by utilizing both qualitative and quantitative data.

Healthcare organizations and policymakers may support the implementation of the DNP role in a clinical setting if they know that it can lead to improved patient outcomes and a higher quality of care and cost savings. Seeing the new role as a positive tool and way to increase their competitive advantage and to improve their financial performance also helps with the implementation process while also addressing the issue of workforce shortages in nursing and other healthcare professions.

Funding and Costs:

To address potential funding and cost concerns, it is important to identify potential sources of funding for the new role, such as grants, Medicaid and Medicare reimbursement, and private insurance coverage (Zaccagnini & Pechacek, 2021). Additionally, it is important to demonstrate the cost-effectiveness of this position using data and research studies.

Theoretical Framework and Evaluation Method

A theoretical framework can assist with the implementation of the new role by providing a clear and consistent approach to the implementation process. One potential theoretical framework that could be used is the Diffusion of Innovations Theory, which suggests that the adoption of new roles and practices is influenced by the perceived relative advantage, compatibility, complexity, trialability, and observability of the innovation (Melynk, & Fineout-Overholt, 2019).

To determine the effectiveness of the new role, it is important to establish evaluation methods that can be used to measure the outcomes of the role. This can include patient satisfaction surveys, quality of care, and cost-effectiveness measures. Additionally, it is important to involve stakeholders in the evaluation process to ensure that the new role is meeting their needs and expectations. Not only does the usage of reliable tools show how credible this position can be to the stakeholders it also shows how it benefits them and the society.

Summary and Conclusion

To be able to indicate how important having a DNP-prepared Don is, the main goal would be to identify the stakeholders which are usually the people who allocate resources for healthcare.  Of course, the chief resource is money since most resources aren’t free.  This means to sell the idea of a DNP-prepared DON to lead any clinic, one must pitch the benefits of that same role to stakeholders who are often not clinicians themselves but rather may have a background in finance or marketing. Education is key since the resistance from many often stems from lack of knowledge (Melnyk & Fineout-Overholt, 2019).  Maintaining and sustaining this position also cannot be easy due to the turnover and churn in healthcare which has increased partly due to the coronavirus pandemic.  For example, being able to show EBP in evaluations that determine compensation is also helpful, since money certainly talks.

Primary care providers are in high demand in the United States, especially in underserved and rural areas. Because of their education and experience, Doctorate degree Nurse Practitioners (DNPs) are able to provide a wide variety of primary care services and may work in tandem with physicians, making them ideal candidates to fill this void. DNP-prepared NPs are better equipped to address this gap than MSN-prepared NPs because of their advanced education and training in areas such as leadership, quality improvement, and evidence-based practice; deeper familiarity with healthcare systems; and proficiency in using data to optimize patient outcomes.

Nursing advocacy serves as a basis for supporting issues affecting nursing practice, the nursing profession as a whole, and health care issues. Every nurse has a professional mandate to advocate for the profession and answer the call to action to be the voice on all issues affecting nursing and patient care (Downs & Fiore-lopez, 2022, p. 40). In general, doctorate-degree nurse practitioners (NPs) should keep up with healthcare policy and legislative developments and push for measures that would strengthen their position as primary care providers. Finally, to be able to make a difference, being involved with policy-making, advocacy must be looked upon as a professional obligation so if everyone finds their voices and uses them not only does it help us as providers, it would also help in pushing forward the agenda to make a difference legislatively.

 

 

 

 

REFERENCES

American Association of Colleges of Nursing. (2006). Essentials of doctoral education for advanced practice nursing. Retrieved from https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

American Association of Nurse Practitioners. (2021). National Nurse Practitioner Sample Survey. Retrieved from https://www.aanp.org/research/nurse-practitioner-sample-survey

American Association of Nurse Practitioners. (2021). National Nurse Practitioner Sample Survey. Retrieved from https://www.aanp.org/research/nurse-practitioner-sample-survey

American Association of Colleges of Nursing. (2006). Essentials of doctoral education for advanced practice nursing. Retrieved from https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Health Resources and Services Administration (HRSA). (n.d.). Primary Care Shortage Areas. Retrieved from https://www.hrsa.gov/shortage-designation/primary-care-hpsas

Larocco, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. Arthur L. Davis Publishing Agency, Inc.

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare (4th ed.). Wolters Kluwer.

Melnyk, B. M., & Raderstorf, T. (2019). Making the case for evidence-based leadership and innovation. Evidence-Based Leadership, Innovation, and Entrepreneurship in Nursing and Healthcare. https://doi.org/10.1891/9780826196255.0001

Moran, K., Conrad, D., & Burson, R. (2020). The Doctor of Nursing Practice Scholarly Project: A Framework for Success. Burlington, Massachusetts: Jones & Barlett.

Mourão Netto, J. J., Rodrigues Silva Júnior, V., Moreira Rodrigues, A. R., Cassimiro Aragão, O., Rutz Porto, A., Buss Thofehrn, M., & Sales da Silva, L. M. (2022). INCLUSION OF NURSING PROFESSIONALS IN PARTY POLITICS: ANALYSIS OF THEIR PARTICIPATION IN THE MUNICIPAL ELECTORAL DISPUTES. Revista Baiana de Enfermagem, 36, 1-10. https://doi.org/10.18471/rbe.v36.46966

National Academies of Sciences, Engineering, and Medicine(2021). The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982  The Role of Nurses in Improving Health Care Access and Quality.

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

Trautman, D., Idzik, S., Hammersla, M., & Rosseter, R. (2018). Advancing Scholarship through Translational Research: The role of PhD and DNP prepared nurses. OJIN: The Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02man02

Zaccagnini, M., & Pechacek, J.  (2021). The Doctor of Nursing practice essentials. (4th Ed.) pp.110  Burlington, MA: Jones & Bartlett Learning.