Combining the research and education components of a PhD program with the clinical practice components of a doctor of nurse practice (DNP) program completes the evidence-to-practice spectrum. It improves evidence-based care and provides outcomes to fuel future research and education. On April 20, 2021, speakers at the 46th Annual ONS Congress™ explained how their institutions created collaborative models that are now a standard component of DNP and PhD programs.

Building Skills at the Doctoral Student Level

Hilaire Thompson, PhD, RN, ARNP, AGACNP-BC, FAAN, from the University of Washington School of Nursing (UW SoN), and Katie Kemble, DNP, ARNP, FNP-C, AOCNP®, FAANP, from UW SoN and Confluence Health, said that the school matches DNP candidates with PhD candidates to collaborate on DNP final projects to address a clinical problem or need identified by an agency, community, or organization, such as:

  • Capacity building
  • Needs assessments
  • Policy initiatives or evaluation
  • Process or practice environment improvement
  • Program planning or evaluation
  • Quality or safety initiative or improvement

The project must be guided by a framework or model for translation of evidence to practice, and students must prepare a report with deliverables.

The school’s innovative program provides structured support throughout the course sequence, with PhD students integrated as consultants to foster early collaboration skills. Weekly reflection is built into the structure, and students are required to consult with their peers every two to three weeks.

By working together, students have created projects on reducing falls, guiding oxygen use at end of life, improving colorectal screening, providing survivor sexual health resources, reducing gaps and delays in care of at-risk patients with cancer, and building a partnership with the Islamic community, among others.

Applying Those Skills to Practice

In 2015, the school joined forces with Confluence Health, the largest medical provider between Seattle and Spokane, to create a mechanism for applying quality initiative research to DNP projects. The partnership provides an opportunity for DNP students to implement a research-driven program directly into practice in an integrated health system across 2 hospitals, 40 medical specialties, more than 300 physicians, and 170 advanced practice providers.

“Our ongoing partnership has allowed the UW SoN to engage with Confluence in a long-term highly synergistic consultancy model, where each side benefits,” Thompson explained. “Confluence now has access to highly skilled nurse scientists and scholars in training that they otherwise would not. And UW SoN students and faculty are now able to work in that system to help address real issues and improve quality of care across a highly diverse region of our state.”

Some of the projects implemented through the collaboration are:

  • Honoring Choices, collaborative adult gerontology primary care nurse practitioner and family nurse practitioner tracks
  • Hematology referrals and primary care initial work-up
  • Algorithm development and collaboration for the adult gerontology primary care nurse practitioner track
  • Education and implementation strategies collaboration for the family nurse practitioner track
  • Teledermatology and management of serious skin lesions
  • Improving the management of recurrent pleural effusions in north central Washington
  • Implementing an outpatient palliative care referral guideline at Confluence Health

Projects planned for the 2020–2021 term include:

  • Two newsletters for north central Washington, one for the oncology community and another for cancer survivors
  • Increasing oncology referrals to supportive services
  • Recognizing and treating serious and nonserious skin lesions