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The UNC Policy Manual400.1.1.5[G]

Adopted 05/23/121

APPENDIX CUNIVERSITY OF NORTH CAROLINA

REQUEST FOR AUTHORIZATION TO ESTABLISHA NEW DEGREE PROGRAM

INSTRUCTIONS: Each proposal should include a 2-3 page executive summary. The signature of the Chancellor is required. Please submit one hard copy and an electronic copy of the proposal to the Office of the Senior Vice President of Academic Affairs at UNC General Administration.

Date: August 22, 2012

Constituent Institution: East Carolina University _

CIP Discipline Specialty Title: Nursing Practice ____

CIP Discipline Specialty Number: ___51.3818 _________ Level: B ___ M ___ 1st Prof ___ D _X__

Exact Title of the Proposed Degree: ___Doctor of Nursing Practice___________________________

Exact Degree Abbreviation (e.g. B.S., B.A., M.A., M.S., Ed.D., Ph.D.): ___DNP____________

Does the proposed program constitute a substantive change as defined by SACS? Yes ____ No _X___

ECU notified SACS on June 28, 2012 that we have been authorized to plan a DNP degree

The current SACS Substantive Change Policy Statement may be viewed at:http://www.sacscoc.org/pdf/081705/Substantive%20Change%20policy.pdf

If yes, please briefly explain.Proposed date to establish degree program: Month ___August_______ Year ____2013_______

Are there plans to offer all or a portion of this program to students off-campus or online? Yes __X__ No _____

If yes, complete the form to be used to request establishment of a distance education program and submit it along with this request.

Note: If a degree program has not been approved by the Board of Governors, its approval for alternative, online, or distance delivery must wait until BOG program approval is received. (400.1.1[R], page 3)

1This Appendix C supersedes the preceding Appendix C entitled, “Request for Authorization to Establish a New Degree Program," adopted May 6, 2009.

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Adopted05/23/12

I. DESCRIPTION OF THE PROGRAMA. Describe the proposed degree program (i.e., its nature, scope, and intended audience).

Nature. The Doctor of Nursing Practice (DNP) degree is a practice-focused terminal degree earned by specialists in advanced nursing practice. The DNP focuses on developing experts in translating and applying research findings into clinical practice rather than in generating new knowledge. According to the American Association of Colleges of Nursing (AACN), “In response to changes in health care delivery and emerging health care needs, additional knowledge or content areas have been identified by practicing nurses. Further, the knowledge required to provide leadership in the discipline of nursing is so complex and rapidly changing that doctoral level education is needed” (AACN, 2004).

The proposed online post-master’s DNP degree will be a 36-semester-hour (sh) program that builds upon the current College of Nursing (CON) master’s level curriculum. The DNP curriculum includes advanced study in scientific underpinnings for practice, health care finance, policy, and leadership, as well as patient safety and risk management. The DNP program provides enhanced knowledge to improve nursing practice and patient outcomes as well as enhanced leadership skills to strengthen practice and health care delivery. A scholarly practice project serves as a cumulative outcome measure of the student’s overall competence and achievement of the educational objectives. Students will gain greater depth of knowledge regarding policy issues, interdisciplinary models of health care delivery, techniques and models for influencing the health care system, particular problems of rural health populations, clinical scholarship to improve quality and safety, and translational research. The proposed DNP degree will address the following objectives in delivery of health care to the people of eastern North Carolina:

Improve patient outcomes through enhanced knowledge of nursing research and practice.

Strengthen nursing practice and health care delivery through enhanced leadership skills.

Link research and practice through the process of translating research from “bench to bedside.”

Improve the health of citizens through the preparation of practitioners who deliver primary care in rural areas of the state.

Enhance clinical nursing practice and improve patient outcomes through innovation in the clinical arena.

Scope and Intended Audience. Based on this knowledge assessment, changes in the level of education of advanced practice nurses were recommended in 2004 (AACN, 2004). AACN recommended increasing the level of preparation necessary for advanced nursing practice roles from the master’s (MSN) to the doctoral level (DNP) with a target date of 2015 for widespread implementation. As of 2015, the DNP would replace the MSN as the educational entry level expected for advanced practice nurses, including

certified nurse midwives (CNMs), certified registered nurse anesthetists (CRNAs), clinical nurse specialists (CNSs), and nurse practitioners [certified] (NPs).

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Adopted05/23/12

This change effectively adds one year of study to the prior MSN preparation of advanced practice nurses.

Since the DNP is a terminal replacement for the MSN degree for advanced practice nurses, the job market and the predicted applicant pool would be the same as the applicant pool and job market for MSN-prepared advanced practice nurses. While the DNP constitutes an enhanced level of preparation, it does not create a new role for advanced nursing practice. Instead the DNP provides advanced practice nurses with additional knowledge and skills that better prepare them to address evolving and increasingly complex societal needs for safe, cost-effective, patient-centered, and accessible care.

Requiring three years for the DNP versus two years for the MSN can be understood to mean that if no enrollment growth monies are available in higher education in North Carolina (NC) to cover one additional year of education for advanced practice nursing students, then the number of CNMs, CRNAs, CNSs, and NPs entering the NC workforce is likely to decrease by as much as 33%-- unless nurses seek DNP degrees from other states. No predictions have been made regarding what percentage of NPs entering the NC workforce will go outside of NC to obtain a DNP degree.

The National Organization of Nurse Practitioner Faculty (NONPF), that sets standards for both Adult Gerontology Nurse Practitioner (AGNP) and Family Nurse Practitioner (FNP) programs has been insistent in acknowledging the DNP as the entry level for advanced practice by 2015. In addition, by 2025 nurse anesthetists will be required to have the DNP degree to meet eligibility requirements for taking their national certification examination. CNSs and CNMs have not yet agreed upon a date by which the DNP will be their expected educational level for being eligible for certification or entry into practice.

ECU proposes to begin offering a DNP program focused on students from the AGNP and FNP concentrations. As additional advanced nursing practice specialty areas mandate the DNP as entry level for their practice, the ECU DNP program would gradually move to include these concentrations as well. Eventually it is anticipated that these advanced practice concentrations, namely, CNMs, CNSs, CRNAs and other NP specialties would be included in the DNP program rather than the MSN program. These concentrations would transition from the MSN to the DNP program in the same manner as described with the current transition of the AGNP and FNP concentrations.

The applicant response to the AACN mandate requiring a DNP as entry into advanced practice has been both immediate and overwhelming. In 2002 there were 70 students in DNP programs nationally; by 2011 (nine years later) this number had grown to 8973 (over 100-fold). In 2011 alone, 1581 advanced practice nurses earned the DNP degree. There are currently 182 DNP programs enrolling students throughout the country (in 37 states and the District of Columbia). Faculty of the ECU CON propose a DNP degree program that will provide a rigorous curriculum that prepares advanced practice nurse leaders to meet the evolving needs of individuals residing in increasingly complex environments.

A frequently expressed concern about the DNP degree is whether or not requiring this enhanced preparation for advanced practice will adversely

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Adopted05/23/12impact the supply of nursing faculty prepared to teach new RNs in community college and university settings. While DNP prepared nurses may choose to teach new RNs, a DNP degree is not required for educating RNs. Requiring the DNP for advanced practice does not change either the discipline’s or NC Board of Nursing’s recommendation that the master’s degree is required to teach entry level RNs. NC schools that are currently offering the MSN to prepare nursing faculty for the associate degree or baccalaureate RN education will continue to offer MSN degree preparation as nurse educators. In fact, it is conceivable that having to choose between two years of study to become a nurse educator and three years to become an advanced practice nurse may invite applicants to better discern if their true vocation lies in educating new RNs for entry into practice or in seeking the demanding clinical education necessary to be employed in an advanced practice role. Historically, ECU CON has been committed to educating clinical nurses and nursing educators at master’s and doctoral levels. From spring 2007 to fall 2011, ECU graduated 130 students from the online MSN nursing education concentration alone. Currently there are 140 students in the nursing education MSN concentration, with this area representing the largest concentration in the entire MSN program. At this time, ECU plans to continue providing the MSN to enhance the nurse faculty workforce needs in NC. In year one of the DNP program, ECU CON proposes to provide the DNP as an online post-master’s program of study for advanced practice nurses primarily prepared as either AGNPs or FNPs. In view of the national trend for preparation of advanced practice nurses at the doctoral level, ECU CON faculty anticipate a large demand for such a program from NC nurses who have already earned a master’s degree and nurse practitioner certification, but wish to continue and earn a doctoral degree. Entry into the post-master’s DNP will require a master’s degree in nursing with a focus in an advanced practice role. During the second year of the DNP program, after the program is well-established, ECU CON will begin moving students currently in the traditional MSN program for AGNP or FNP concentrations immediately into the post-master’s curriculum after they graduate with the MSN degree. The last AGNP and FNP students will be admitted to the current MSN program in 2013. The CON has traditionally maintained approximately 145 FNP and AGNP students in the MSN program. The CON will accept its first cohort into the post-baccalaureate DNP program in fall 2014. Thus the advanced practice concentrations will transition quite rapidly from traditional master’s degree programs to a post-baccalaureate-to-DNP program. Students will complete 21 semester hours of 6000-level courses before beginning all doctoral level courses. The post-master’s DNP option will remain open after the second year of the program, but will have limited enrollment (approximately 20 students/year) unless additional financial resources become available.

The ultimate entry level degree for the baccalaureate-to-DNP program will be a bachelor of science in nursing. Although initially the program will be focused on preparing AGNP and FNPs at the DNP level, as other clinical specialties mandate the DNP entry level, the traditional master’s program in those concentration areas will be phased out and the post-baccalaureate-to-DNP program will enlarge. There will continue to be students in the nursing leadership and nursing education concentrations who will need the MSN degree for future employment. Thus, due to high demand, the master’s program in nursing at ECU will continue to be offered for these specialty

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Adopted05/23/12areas. Currently there are over 220 students enrolled in the nursing leadership and nursing education options combined.

B. List the educational objectives of the program.

The proposed educational objectives for the DNP degree are to graduate a student who will:

Assume leadership roles to advance clinical practice and health care delivery.

Influence policy, care delivery, and systems for current and future health care needs. Translate scientific, theoretical, and ethical principles into health care for individuals, families, and populations.

Translate scientific, theoretical, and ethical principles into health care for individuals, families, and populations.

Implement new technologies and evidence-based practices to optimize health care outcomes, reduce risks, and promote patient safety.

Develop partnerships with key stakeholders to address the unique health care needs of various groups.

C. Describe the relationship of the program to other programs currently offered at the proposing institution, including the common use of: Courses, Faculty, Facilities and Resources:

The proposed DNP degree program complements a number of academic offerings at ECU. Within the CON, the DNP degree extends the current master’s program by providing students with expertise in policy, leadership and advocacy. Students in the DNP degree will work synergistically with students in the CON PhD program. While PhD students conduct research and develop new science, the DNP students will translate that research into best practices in the health care service delivery system. In addition to collaboration with our own PhD program students, DNP students will also develop collaborative relationships with students in other practice doctoral programs within the Health Sciences Division such as the Doctor of Physical Therapy, PhD in Communication Sciences and Disorders, PhD in Rehabilitation Counseling, Doctor of Audiology, PhD in Medical Family Therapy, and the PhD in Health Psychology. Collaboration with students in the Brody School of Medicine and the School of Dental Medicine may also occur.

Students who are enrolled in campus-based programs and online programs use many of the same agencies for clinical practice and this facilitates collaboration among clinical disciplines. Students will collaborate as well when their clinical practice occurs on campus in areas such as Student Health Services or in the acute care setting at Vidant Medical Center.

The college is fortunate to be situated within a Division of Health Sciences that includes the Brody School of Medicine, the College of Allied Health Sciences, the School of Dental Medicine, and the Health Sciences Library. The faculties of these schools will be a valuable resource for collaboration. For example, faculty in the CON and the Brody School of Medicine have begun collaboration in the inter-disciplinary use of the virtual clinic developed at the College of Nursing. College of Nursing faculty helped the new School of Dental Medicine establish many of its processes and anticipate a meaningful collaboration with its faculty in dealing with clinical care issues where there is an oral care component. Faculty in the College of Allied Health

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Adopted05/23/12Sciences currently provide statistical consultation for both nursing faculty and doctoral students in the PhD program and we anticipate this collaboration to be especially meaningful with the DNP students’ scholarly projects. The Department of Bioethics and Interdisciplinary Studies offer courses in social and cultural dimensions of health care. In addition, the department of public health faculty frequently collaborate with nursing faculty in teaching and research.

The DNP program also extends the work of a number of existing programs of research, community engagement, and service at ECU. Programs outside of the ECU CON where collaboration could be mobilized include the East Carolina Diabetes and Obesity Institute, the East Carolina Heart Institute, the ECU Center for Health Disparities Research, and the Brody School of Medicine Regional Perinatal Center. Internally, the East Carolina Center for Nursing Leadership (ECCNL) and the Bariatric Nursing Consortium will provide opportunities for students to collaborate with faculty involved in research and community engagement. Additionally, the proposed DNP degree addresses specific priority outreach initiatives identified by ECU including the military population and the needs of vulnerable populations within this region.

Partnership Opportunities within ECU

The faculty in the CON work closely with other health care providers in the East Carolina Heart Institute (ECHI). The ECHI encompasses both a research and education facility which is part of ECU and a clinical care facility associated with Pitt County Memorial Hospital, now Vidant Medical Center. The latter is a $160 million bed tower for in-patients that houses 120 cardiovascular beds, six operating rooms, seven interventional laboratories and three electrophysiology labs. All are designed to create optimal patient care environments for patients of eastern NC. Faculty and students in the DNP program will collaborate with ECHI to enhance the care of cardiovascular patients.

The ECU Diabetes and Obesity Institute was established as a result of the work of physicians and scientists in the Brody School of Medicine working in the area of bariatric surgery. The ECU Diabetes and Obesity Institute now studies obesity as well as diabetes and related conditions and is comprised of researchers and scientists from many disciplines throughout the university. CON faculty are among its members and will facilitate interdisciplinary approaches to the management of these issues that are important to the health and quality of life in eastern NC. DNP students will learn to partner and collaborate more effectively in addressing diabetes and its related syndromes by working with this institute.

The ECU Center for Health Disparities Research was recently established at ECU to organize campus and community efforts with the goal of improving quality of life and eliminating health disparities in eastern NC through research. For example, Dr. Elizabeth Jesse’s research in the areas of clinical and translational research in rural health care has focused on racial/ethnic health disparities in perinatal depression and preterm birth. Dr. Kim Larson’s research engages community partners in her community-based participatory research that focuses on the sexual risk among Latino adolescents in rural NC. A DNP student interested in health disparities issues such as these may collaborate with these researchers to facilitate the implementation of evidence-based strategies for women and infants and Latino adolescents.

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Adopted05/23/12Other partners external to the CON are the College of Health and Human Performance, the College of Human Ecology, the Thomas Harriot College of Arts and Sciences, and the other departments within the Health Sciences Division.

Partnership Opportunities within the CON

The Bariatric Consortium, a nursing research group, was developed within the CON as a response to the growing national obesity epidemic. The consortium is composed of both nurse faculty and practice-based nurses from Vidant Medical Center. Members of the Consortium have generated numerous publications and were instrumental in establishing the Journal of Bariatric Nursing and Surgical Patient Care, a peer-reviewed journal. The group founded the National Association of Bariatric Nurses, an organization which includes over 900 nurses devoted to improving the care of morbidly obese patients. In 2007, the work of the Bariatric Nursing Consortium resulted in Vidant Medical Center receiving the Magnet Prize for development of this new nursing specialty. DNP students will work with this research group to conduct translational research that mobilizes best practices in the care of obese patients.

The East Carolina Center for Nursing Leadership (ECCNL) is another vehicle for transforming research findings in the practice setting. Approximately one-half of the nurses in director or executive nursing leadership positions in eastern NC are educated only at the associate degree in nursing level. Developing the DNP program to educate clinicians in leadership, financial competence, and policy development will advance ECCNL’s mission to prepare nurses to lead and partner with communities to improve health. Initially funded by a grant from the Robert Wood Johnson Foundation, the focus of the ECCNL is improving the leadership skills of nurses and nursing students. The center works with rural communities to stimulate dialogue, interest, and attention regarding nursing leadership capacity and competence in regional health care organizations.

The CON has extensive relationships with rural hospitals and clinical agencies throughout the eastern part of the state. These agencies provide opportunities for DNP students to practice. In addition the graduates of the DNP program will elevate the level of care as they move back into these rural agencies. While didactic work is done totally online, clinical work is carried out in health care agencies such as hospitals, public health agencies, or other clinical sites.

A particularly important population in eastern NC is military personnel and their families, and ECU recognizes and honors this commitment. ECU is a recipient of the 2010 Secretary of Defense Employer Support Freedom Award, the highest recognition given by the United States government to employers for their outstanding support of their employees who serve in the National Guard and Reserve. ECU is one of only 15 employers selected to receive the honor from nearly 2,500 nominations submitted nationwide. The CON has an extensive network of educational affiliations with military personnel and facilities. The CON is surrounded by military bases in Goldsboro, Havelock, Cherry Point, and Fort Bragg. The CON has military students in its master’s program, and several students in ECU’s master’s program also have clinical placements in area military hospitals. The CON also employs a number of

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Adopted05/23/12retired officers from the Air Force, Navy and Army who mentor and develop future members of the military.

The CON currently is planning a new specialty option, family psychiatric/mental health nurse practitioner, in response to a growing concern about military personnel and their families in eastern NC. There is a great need for mental health services following multiple deployments. Development of this option will enable the CON to provide practitioners to these rural areas, particularly Onslow County, where the need is very high. The faculty anticipates opening this concentration as soon as resources become available. DNP students can focus in psychiatric/mental health and develop extensive projects to address military health care needs in local communities. A DNP student interested in mental health will be able to collaborate with personnel in clinical settings to facilitate the implementation of evidence-based strategies for military personnel and their families experiencing deployment stress and post traumatic stress. Thus, development of the DNP will accomplish ECU’s commitment to military families and patients as well.

Common Use of:

1. Courses

DNP students may select relevant electives (cognates) also taken by students in the nursing PhD program as well as by a variety of students in graduate programs such as public health, allied health, nutrition, and psychology.

2. Faculty

The DNP program will share some of the faculty with the PhD in nursing program, particularly those well-versed and current in research, evidence-based practice, economics, and health policy. Because DNP students will be expected to complete a scholarly project as their terminal requirement, faculty with current knowledge and experience in research will be expected to oversee and assist DNP students with supervising these projects. The CON currently has five DNP- prepared faculty, two faculty enrolled in DNP programs, as well as twenty-seven faculty prepared and credentialed as advanced practice nurses at the doctoral or master’s level. There are 47 CON faculty members with graduate faculty status. Faculty in the Brody School of Medicine teach pharmacology and physiology.

3. Facilities

The DNP program will share some classroom space currently used with PhD and MSN students in the ECU CON. Because the DNP program will be primarily online, there should be less of a demand for classroom space than if the program were offered entirely face-to-face. A shortage of classroom space is not expected as a by-product of offering a DNP program.

4. Other resources

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Adopted05/23/12ECU CON faculty planning the DNP program recognize that enrollment increase funds are not likely to be available. Because of the high priority of this program, ECU is willing to commit some resources to its implementation. An associate dean for Graduate Programs who has directed a DNP program in a previous position elsewhere can assist the AGNP/FNP Concentration Director in program oversight for ECU. Two FTEs have been committed to the new DNP program by the Vice Chancellor for Health Sciences (Attachment A). Finally, ECU CON has revised enrollment projections downward and changed their plans to move expeditiously to a BSN-to-DNP entry program in order to ensure students can be accommodated without additional resources should enrollment growth dollars not become available.

Available faculty positions that arise in the future will be announced in journals that potential DNP faculty would be most likely to read. Since the DNP program will be totally online there will be email announcements sent to other schools and colleges of nursing in the hopes of attracting DNP graduates of their programs as potential faculty members.

The ECU CON should receive $12,000 in one-time operating dollars for two additional faculty positions (2 additional faculty members in Year 1). In addition, $2,000 per faculty member is allocated for travel annually in years one and two and increased to $2,500 per faculty member per year in years three through five for professional conferences, continued licensing, and training that can be generated internally through the CON faculty practice plan.

The ECU CON is requesting a tuition increase of $100/credit hour for all DNP students. The additional revenue will be used to support need-based financial aid and recoup some of the costs of offering graduate clinical programs such as clinical site placements, meeting clinical agency requirements for safety and legal compliance, maintaining a high fidelity simulated learning laboratory, and recruiting and retaining faculty to teach in graduate clinical programs.

D. Identify opportunities for collaboration with institutions offering related

degrees and discuss what steps have or will be taken to actively pursue those opportunities where appropriate and advantageous.

Recognizing the value of collaboration in the development of the DNP, the CON has discussed with faculty and administrators from UNC-Wilmington, Fayetteville State University, and UNC-Pembroke the possibility of developing collaborative relationships that would benefit all parties.

UNC Wilmington and ECU have a Memorandum of Understanding (Attachment B) concerning the intent to collaborate with one another. Within the context of this MOU the two institutions have agreed to continue efforts toward a collaborative arrangement. Although ECU does not have an MOU with Fayetteville State University there is agreement to continue conversations and possibly develop mutually beneficial collaborations. Although the schools and programs are at varying levels in terms of degrees offered efforts to find collaborations at the course level will continue.

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Adopted05/23/12UNC-Pembroke and the CON have made definite arrangements to collaborate and a letter to this effect is attached to this proposal (Attachment C). Although the two institutions will continue conversations over the coming months, the intention is to facilitate admission of 10% of ECU’s seats in either the post-master’s DNP or the BSN-DNP program for UNC-Pembroke students and/or faculty members. The CON will provide consultation to UNC-Pembroke faculty as they begin to utilize their new simulation technology and will move to develop collaborative research relationships with the two faculties. UNC-Pembroke is developing an MSN program with focus areas in rural case management and the clinical nurse leader role which may be of substantial interest to some of ECU graduates and students. UNC-Pembroke faculty will assist in the development of research sites for either DNP students or faculty, particularly for those who desire an area of diversity. UNC-Pembroke faculty also will have the opportunity to serve on committees for scholarly projects emanating from the ECUDNP four-part scholarly practicum.

II. JUSTIFICATION FOR THE PROGRAM – NARRATIVE STATEMENT A. Describe the proposed program as it relates to:

1. Institutional mission One of the greatest needs of NC is to improve the health and wellness of its citizens. Addressing this need is a major strategic initiative found in the UNC Tomorrow plan. (2007) Improving health is a particularly important concern in eastern NC where infant mortality and morbidity and adult mortality from virtually all major diseases are particularly high (NC State Center for Health Statistics, 2010). The need for additional highly skilled practitioners is great. The proposed DNP program supports the strategic plans of both ECU and the UNC system. The Strategic Plan of ECU, ECU Tomorrow: A Vision for Leadership and Service, outlines “Health, Health Care, and Medical Innovation” as a major strategic direction of the university. http://www.ecu.edu/cs-admin/mktg/ecu_tomorrow/our_strategic_directionions.cfmIt notes that ECU will save lives, cure diseases, and positively transform the quality of health care for the region and state. Specifically it notes that ECU will expand research in health sciences with a particular emphasis on the health concerns of the region and state, with a particular focus on research in rural health care, racial/ethnic health disparities, diabetes and obesity, cancer, cardiovascular diseases, sensorimotor defects, quality care, and patient safety.

The DNP degree prepares nurses who can translate and implement evidence-based interventions into clinical nursing practice. It is particularly challenging for busy clinicians to integrate research in their daily practice, but the DNP offers an avenue for enabling this integration. The DNP graduate will serve as a critical link between researchers and other practitioners who will focus on the process of translating research from “bench to bedside.” The DNP graduate will collaborate with nurse researchers in ECU’s CON PhD program as well as with other researchers at ECU and throughout the state and nation to implement evidence-based care. The DNP program will promote outreach and engagement by placing students in rural areas where

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http://www.ecu.edu/cs-admin/mktg/ecu_tomorrow/our_strategic_directionions.cfm



Adopted05/23/12they can apply, translate, and communicate evidence-based practices and advance research that addresses the specific health concerns of North Carolinians. Further, through the advanced education of nurses, the ECU institutional mission will facilitate individuals, families, and groups in achieving optimal well-being.

Finally, the DNP program helps ECU advance its reputation as the Leadership University. ECU defines leadership as a relational process of inspiring, empowering, and influencing positive change. Nurses prepared with a DNP degree will be able to collaborate with other disciplines to address needed changes in care processes and health care delivery. These graduates will be expertly prepared to assume leadership roles in quality initiatives, clinical program management, and executive training.

2. Strategic plan

ECU Tomorrow: A Vision for Leadership and Service emphasizes the development of partnerships for outreach and engagement in promoting health and economic prosperity.http://www.ecu.edu/cs-admin/mktg/ecu_tomorrow/our_strategic_directionions.cfm. The university is situated amid the largest military community in the state while simultaneously serving some of the poorest counties in the state (Boston, 2008).

ECU’s DNP program faculty and students will work with military facilities and personnel in selected courses. Additionally, the DNP degree will lead to improved health of people living in NC by preparing practitioners to deliver primary care in rural areas of the state and to a culturally diverse population. The degree will equip advanced practice nurses to address the primary health concerns within the eastern part of the state, including cardiovascular diseases, diabetes, obesity, and mother/baby wellness. DNP graduates will be prepared to focus extensively on the translation and application of evidence-based nursing practice. Graduates will be able to translate research into relevant nursing interventions and use clinical innovations to improve nursing practice and subsequently patient outcomes.

3. Responsiveness to local, regional, or statewide needs

The Institute of Medicine (IOM) Reports with Regard to Healthcare. In Health Professions Education: A Bridge to Quality, the IOM committee on Health Professions Education stated that “All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” One question that emerges from that IOM report is “How can the field of nursing focus more heavily on evidence-based practice, quality improvement approaches, and informatics within nursing education programs and reduce health care errors?” (p9)

History of Healthcare Disciplines. Doctoral programs in nursing and other practice disciplines are divided into research-focused and practice-focused programs. Practice - focused programs, such as DNP

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Adopted05/23/12programs, focus on both direct care provided to patients by various clinicians as well as on direct care policies, programs, and protocols that are organized, monitored, and continuously improved upon by expert nurse clinicians. The majority of research-focused programs in nursing offer a PhD. The DNS or DNSc are offered through professional doctoral programs, yet few differences from PhD programs have been found by the AACN when extracting quality indicators. As a result, an AACN Task Force recommended that all of those doctoral programs be designated as research-focused - and that a more heavily practice-focused type of doctoral program (DNP program) be developed. The addition of practice-focused doctoral programs was deemed as both nonthreatening to enrollments in existing research-focused doctoral programs while also filling an unmet need for nurses who desired to earn a doctorate focused on practice instead of research.

Local and Regional. Nursing continues to face a critical shortage of primary care practitioners in the US. The graduate program at ECU CON is strategically equipped to address this shortage across several fronts. The master of science in nursing (MSN) program prepares graduates to provide advanced practice nursing care; to teach students in Associate Degree (ADN) and baccalaureate (BSN) programs; and to provide leadership in hospitals, clinics, and public health agencies in NC, particularly eastern NC. All graduates are eligible for certification in the specialty. ECU CON prides itself that 98-100% of its AGNP, FNP, CNM, NNP, and CRNA graduates successfully pass their respective certification exams on the first attempt and that this range of passing is longstanding and stable.

State. ECU is the largest provider of baccalaureate and advanced practice nurses in NC. Primary care providers can make a difference in both serving health care needs and improving health. NC is known for having ethnically and medically-diverse populations who experience high poverty, are at high risk for a wide variety of diseases and health conditions, and are medically-underserved.

The overarching purpose of the DNP program is to promote career advancement in nursing through the AGNP and FNP concentrations and subsequently to other areas of advanced nursing practice concentration. In turn, the majority of advanced practice nurses who are educated at ECU remain and practice in NC.

The major cost of not acting is that NC nurses devoted to practice would not have the highest level of education available to them and the citizens of NC would not have access to advanced practice nurses prepared at the most comprehensive level necessary to meet the care needs of NC citizens and to redress care access issues. There are currently four states bordering NC that offer the DNP program. Those states and the number of DNP programs offered per state include: Virginia (5), Tennessee (3), South Carolina (2), and Georgia (2). Nurses living in NC could move or take courses in neighboring states via distance-enhanced technologies. In either case they would be paying out-of-state tuition and they would be vulnerable to being recruited to those states. The loss would include “brain drain” where nurses who are highly motivated to deepen their commitment to

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Adopted05/23/12practice through pursuit of higher education would be lured away. NC hospitals and clinics would face challenges recruiting advanced practice nurses for direct patient care and leadership, the citizens of NC would be deprived of access to advanced practice nurses with the highest level of academic preparation, and schools of nursing would be challenged to find doctorally prepared faculty for educating nurses for entry into practice as RNs or advanced practice nurses.

4. Student demand. Discuss the extent to which students will be drawn from a pool of students not previously served by the institutionPotential Student Interest in Pursuing a DNP Degree at ECU. There is ample indication that the proposed program will attract quality students. The demand for the CON master’s program is very strong, as online programs provide educational access for many who otherwise would be unable to pursue graduate study. The FNP and AGNP concentrations, for example, have many more highly qualified applicants than can be accepted for each class cohort. This past year there were 219 qualified applicants for 50 slots. Fifty students were accepted, but the college was forced to reject the applications of another 179 students, many of whom were extremely strong and well-qualified. To date, one student studying at ECU withdrew from the Family Nurse Practitioner concentration to enroll in a DNP program. The college receives weekly inquiries regarding the DNP degree at ECU from nurse practitioners seeking the clinical doctorate.

In April 2012 the college surveyed all its alumni who graduated since 1972 for whom email addresses were available. Alumni were asked to indicate their level of interest in the DNP, ranging from “none” to “significant.” There were 619 respondents, of whom 190 (31%) indicated a “significant” interest and another 139 (23%) indicated a “moderate” interest.

The college also surveyed its currently-enrolled baccalaureate students and master’s students. There are currently 544 master’s students of whom 271 responded to the survey. Of these 105 (39%) indicated a “significant” interest and 79 (29%) indicated a “moderate” interest in the DNP. Similar results were obtained from the currently-enrolled baccalaureate students. There are currently 666 students at that level of whom 265 responded to the survey. Of these 111 (41%) indicated a “significant” interest and 79 (29%) indicated a “moderate” interest in the DNP.

5. Employment opportunities. Document need for proposed degree recipients in the region, the state, or nationally.In October 2010 the Institute of Medicine and the Robert Wood Johnson Foundation released a landmark report on The Future of Nursing. One of the recommendations was that the number of nurses in the U.S. workforce with doctoral degrees should be doubled. In addition, this report stressed that an improved education system was needed to assure that nurses had lifelong access to increasingly higher levels of education that would assure a nursing workforce equipped with the competencies and breadth of knowledge necessary to delivering high quality, cost effective, patient-centered care in a system that is characterized by complexity, fragmentation, and

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Adopted05/23/12unevenness in access to care. With its recommendation to double the number of nurses with doctoral degrees (both DNP and PhD) by 2020, The Future of Nursing report recognized that nurses with doctoral degrees represented less than 1% of the nursing workforce. Doctorally prepared nurses are needed to not only advance clinical practice and to build nursing science, but to also fill the critical need for faculty to prepare the next generation of nurses.

According to the North Carolina Institute of Medicine (NCIOM), the state is likely to experience a shortage of nurse practitioners and other primary care providers in the next 10-20 years. Further, NCIOM Priority Recommendation 8.1 indicates that the North Carolina General Assembly should direct the University of North Carolina System to explore further expansion of nurse practitioner programs (Expanding Access to Health Care in North Carolina: A Report of the NCIOM Health Access Study Group, 2009). According to the Bureau of Labor Statistics, Occupational Outlook Handbook, 2010-11 Edition “all four advanced practice specialties—clinical nurse specialists, nurse practitioners, nurse-midwives, and nurse anesthetists—will be in high demand, particularly in medically underserved areas such as inner cities and rural areas. Relative to physicians, these RNs increasingly serve as lower-cost primary care providers.”

The market for advanced practice nurses will only continue to rise due to: 32 million Americans soon to qualify for health care consequent to the Affordable Care Act, increased restrictions placed on the number of hours medical residents are allowed to work, Centers for Medicare & Medicaid Services (CMS) tying hospital reimbursement rates to low readmissions, and the ever-increasing nursing faculty shortage.

An indicator of demand for graduates is the degree to which current graduates of the FNP and ANP programs find employment as advanced practice nurses. Most recently the CON surveyed the cohort of students who graduated from the FNP/ANP program in December 2011. Twenty-four students (50%) responded to the survey, of whom 23 (96%) reported that they were employed as nurse practitioners as of February 20, 2012. The one student who was not employed reported that he went to China after graduation and was only now returning to seek employment.

B. Discuss potential program duplication, program competitiveness, and opportunities for collaboration in the delivery of the program.

1. Identify similar programs offered by public and private universities elsewhere in North Carolina. Indicate how the proposed new degree program differs from other programs like it within UNC. If the program duplicates other UNC programs, explain:At the present time, the only DNP programs in NC are from private institutions, Duke University and Gardner-Webb University. Thus, very little in-state competition exists.

a. Why the proposed program is necessary or justified, and

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Adopted05/23/12As mentioned above, currently there are no DNP programs within the UNC System. Presently six universities within NC (East Carolina University, UNC-Chapel Hill, UNC-Charlotte, UNC-Greensboro, Western Carolina University and Winston-Salem State University) are proposing to expand their graduate clinical programs to offer the DNP degree. There currently exists an infrastructure at these schools to prepare advanced practice nurses. A variety of specialties are offered at the various institutions. ECU prepares the following specialties: Family Nurse Practitioner (FNP), Adult Gerontology Nurse Practitioner (AGNP), Nurse Midwives, Nurse Anesthesia, Clinical Nurse Specialist, and Neonatal Nurse Practitioner. We are the only school in NC that prepares nurse midwives and the only public institution that prepares neonatal nurse practitioners. Each institution has preceptors in place to assist in clinical preparation of advanced practice nurses in these specialty areas, as well as faculty to teach these specialties. All of these programs are necessary in our state to meet the workforce demand. Elimination of programs would lessen the number of nurses being prepared, decrease the student credit hour production in the university, and would potentially impact the selected regions of the state in which graduates would seek employment upon graduation.

Two elements make the DNP program at ECU CON distinctive. They are the strong relationship that the CON enjoys with the military and its emphasis on rural underserved and vulnerable populations.

East Carolina is surrounded by the state’s military bases and the CON has enjoyed a very strong collaborative relationship with the military for some time. Advanced practice nursing students have their clinical rotations in military facilities and are precepted by active duty military nurses. Several faculty at the CON who teach in advanced practice concentrations have had distinguished careers in the military prior to coming to ECU and they are committed to advancing the care of active duty and veteran soldiers in the region. In 2010, ECU received the Secretary of Defense Employer Support Freedom Award, the highest recognition given by the United States government to employers for their outstanding support of their employees who serve in the National Guard and Reserve.

The CON currently is planning a nurse practitioner option in psychiatric/mental health nursing. This was initiated because of the large number of military personnel returning from deployment with post-traumatic stress syndrome and other deployment-related health issues. These soldiers, as well as their families, need psychiatric intervention, but psychiatric care in eastern North Carolina is very limited. The option is being developed with the active support of leaders at the military bases and at the corporate level in Washington, D.C.

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Adopted05/23/12The DNP emphasis on rural underserved and vulnerable populations also will make this program distinctive. The eastern part of North Carolina particularly lends itself to a program of this type because of very high poverty rates, high morbidity and mortality of the population, and strong minority presence. The online nature of the program allows advanced practice nurses who are DNP students to remain in their communities while engaged in the program of study. This, in turn, means that their services to their communities are not lost during the time when they are engaged in the program. The need for additional skilled practitioners in eastern NC is great and the proposed program will help meet this need.

b. How all or portions of the curriculum might be offered collaboratively with another UNC institution.

As discussed in I. D, there have been discussions with UNC-Pembroke, Fayetteville State University and UNC-Wilmington. Specific plans for collaboration with faculty at UNC-Pembroke have resulted, specifically related to overseeing the culminating scholarly projects, Scholarly Practicum I-IV, and the course addressing quality of care, Application of Best Practices in Interdisciplinary Settings. These collaborative efforts should be very useful and serve both institutions and regions significantly.

2. If the program is a graduate or first professional degree, compare it with other similar programs in public and private universities in North Carolina, in the region, and in the nation. Where appropriate, describe how all licensure or professional accreditation standards will be met, including required practica, internships, and supervised clinical experiences. The DNP curriculum prepares nurses for a tripartite role in advanced nursing practice, clinical leadership/health advocacy, and practice inquiry. Graduates use their advanced preparation to manage increasingly complex patient situations, to identify patterns of need in panels of patients experiencing similar health threats, to appraise and compare the evidence for care effectiveness, and to provide leadership for quality improvement in health care environments.

The curriculum requirements for the DNP are driven by the The AACN Essentials of Doctoral Education for Advanced Nursing Practice (Attachment D). These include content on:

Scientific Underpinnings for Practice Organizational and Systems Leadership for Quality

Improvement and Systems Thinking Clinical Scholarship and Analytical Methods for Evidence-

Based Practice Information Systems/Technology and Patient Care

Technology for the Improvement and Transformation of Health Care

Health Care Policy for Advocacy in Health Care Interprofessional Collaboration for Improving Patient and

Population Health Outcomes

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Adopted05/23/12 Clinical Prevention and Population Health for Improving the

Nation’s Health Advanced Nursing Practice

While each DNP program will base its curriculum on The AACN Essentials of Doctoral Education for Advanced Nursing Practice, programs will differ based on the focus of the advanced practice programs offered, the constellation of faculty teaching those programs, their student applicant pool, and the culture and mission of each campus.

Duke and Gardner-Webb’s programs are the only two DNP programs offered in NC at this time. The post-master's Doctor of Nursing (DNP) Program at Gardner-Webb University is a 36-semester-hour program in three modules offering two areas of specialty education for students with master's degrees in nursing: advanced practice leadership and educational leadership. Course work is presented in an executive format requiring 40 clock hours of on-campus classes each semester for each 3 semester hours of study. The balance of the semester is followed by online lectures, presentations, writing assignments, and interactive class discussions using Gardner-Webb University's distance learning system. Duke University offers a post-master’s and a BSN-to-DNP option for students. The post-master’s option is a 35-semester-hour program that is online with four executive on-campus sessions.

The Commission on Collegiate Nursing Education (CCNE) is the leading accrediting agency for baccalaureate and higher degree nursing programs in the United States. The BSN and MSN programs at ECU CON are currently accredited by this body. This organization has a process for accrediting DNP programs and has published the DNP Essentials and the DNP Roadmap to define the essential curricular elements of the DNP degree. The ECU CON has notified CCNE of its intent to establish a DNP program and is using these guidelines to prepare the DNP curriculum.

Ranking among the nation’s top 20 distance education master’s or doctoral nursing programs in 2012 (http://www.ecu.edu/cs-admin/news/rankings112.cfm, the CON will use innovative technology to provide an evidence-based curriculum with a combination of synchronous and asynchronous formats to meet program objectives. The Essentials of Doctoral Education for Advanced Nursing Practice (http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf ) and the Practice Doctorate Nurse Practitioner Entry-Level Competencies (http://www.nonpf.org/associations/10789/files/DNP%20NP%20competenciesApril2006.pdf ) provide the theoretical and pedagogical foundations for evaluative outcomes and for ensuring that graduates meet licensure, certification and practice requirements. Nationally-certified faculty with demonstrated scholarship and content expertise will provide oversight and mentorship in the assimilation and translation research and leadership in the delivery of advanced practice nursing in diverse and complex health systems.

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http://www.nonpf.org/associations/10789/files/DNP%20NP%20competenciesApril2006.pdf


http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

http://www.ecu.edu/cs-admin/news/rankings112.cfm


Adopted05/23/12ECU College of Nursing was named a Center of Excellence for 2011-2015 by the National League for Nursing in recognition of its outstanding achievements in student learning and professional development. Only nineteen schools in the nation currently hold this designation and ECU CON is a repeat designee, having first won the designation in 2008.

Since 2004, the National League for Nursing has invited nursing schools and colleges to apply for this designation based on their ability to demonstrate sustained excellence in faculty development, nursing education research, or student learning and professional development. Schools must show a commitment to continuous quality improvement. The award to ECU CON was made in recognition of the College of Nursing’s creation of student-centered learning environments that demonstrate excellence in nursing education.

C. Enrollment (baccalaureate programs should include only upper division majors, that is, juniors and seniors).

Headcount enrollmentShow a four-year history of enrollments and degrees awarded in similar programs offered at other UNC institutions (using the format below for each institution with a similar program); indicate which of these institutions you consulted regarding their experience with student demand and job placement. Indicate how their experiences influenced your enrollment projections. There are no other UNC institutions currently offering the DNP, thus there is no data on headcount enrollments for such programs. The CON enrollment projections were thus developed based on the large number of inquiries that continue to be received by the faculty concerning the availability of the DNP, as well as data from surveys already cited. A very strong demand for this program is anticipated and thus enrollment projections are based on the current FNP/ANP enrollment plus projections concerning availability of resources with which to offer the new degree. Institution: _____________________________________________________________

Program Title: _____________________________________________________________

(year) (year) (year) (year)

Enrollment

Degrees-awarded

The projected enrollment in the proposed program is as follows:

Enrollment in the proposed program would peak in year 4 and reach its target enrollment of 170 students in year five. At that point the program would have transitioned to predominantly BSN-to-DNP students and we would continue offering the post-master’s option to 20 students per year.

Year Plan for Enrollment Page 18 of 40


Adopted05/23/12

* Year 12013

In fall of Year 1, 20 students will be enrolled in the first year of the post-master’s (PM) DNP program. During that year there will also be 50 students in the first year and 50 students in the second year of the traditional MSN program. Thus the total for Year 1 will be 120 students-- of whom 20 are new PM DNP students. This (2013) is the last year that the CON will admit students to the traditional MSN program in the adult-gerontology and family nurse practitioner concentrations.

Year 22014

In fall of Year 2 the 20 PM students will move to year 2 of the PM program. We will admit another cohort of 20 new students to the PM DNP program. In addition we will admit approximately 40 AGNP and FNP students who graduated the preceding May into the PM DNP program. Total for the PM program is thus 80, of whom 20 will graduate in December, leaving 60 students in the PM program. The group that was in its first year of the traditional MSN program (50 students) will move up to the second year. In addition, we will accept a new cohort of 50 students to the post-BSN-DNP program. Thus the total number of DNP students for Year 2 in the fall will be 180 students and by the end of the year that number would reduce to 160 net.

Year 32015

In fall of Year 3 the 60 students remaining in the PM program will move to their second year. We will admit another cohort of 20 new students in the PM DNP program. The 50 students who were in the 2nd year of their traditional program would have graduated in the preceding May and would move to the 1st year of the PM program. Total PM students = 130.

The 50 students who entered the post-BSN-DNP curriculum the previous year would move to their second year. We would accept another cohort of 50 students in the first year of the post-BSN DNP curriculum. Thus the total for fall of year 3 would be 230 students and, subtracting the 60 students who would graduate in December, the total would be 170 students net.

Year 42016

In fall of Year 4, the 50 students who entered the post-BSN-DNP program the preceding year would move to their 2nd year. The 50 students who were in their second year in Year 3 would move to their third year in the post-BSN DNP program. We would accept another cohort of 50 students in the first year of the post-BSN-DNP curriculum.

We will admit another cohort of 20 new students in the PM DNP program. In the PM program the 70 students who were in the first year would move to their 2nd PM year.

Thus the total for Year 4 would be 240 students of whom 70 PM students would graduate after one semester leaving a net total of 170 students.

Year 52017

In Year 5, the 50 students who completed their 3rd year of the post-BSN-DNP program would need an additional ½ year to complete the DNP program. The 50 students in their 2nd year of the post-BSN-DNP program would move to their 3rd year. The 50 students in their 1st year of the post-BSN-DNP program would move to their 2nd year. We would accept an additional 50 students in the 1st year of the post-BSN-DNP program.

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Adopted05/23/12

In the post-masters DNP program we will admit another cohort of 20 new students. The 20 PM students admitted in year 4 would need an additional semester. Total number of students for year 5 would be 240, of whom 70 would graduate in December, leaving a total of 170 net students for the remaining part of year 5.Thus the expected enrollment target for five years is 170 net students.

Enrollments and progression in BSN-DNP and post-master’s DNP program, by year

Year PM DNP Post-BSN-DNP MSN 2nd yr

MSN 1st Yr Total

Year 1 (2013) 20 0 50 50 (last admission into tradit. MSN)

120

Year 2 (2014) 20 + *20+ 40=8060

(*20 grad. In Dec)

50 50 180160

Year 3 (2014) *60 + 20 +50 =13070 (*60 grad. In fall)

50 + 50=100 230170

Year 4 (2015) *70 + 20=9020

* 70 grad. In Dec.

50+50+50=150 0 200170

Year 5 (2016) 20 +* 20=4020

(*20 grad. In Dec.)

50+50+50+*50=200150

(*50 grad. Dec.)

240170

Total Students 360 450 100 50 970

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Adopted05/23/12

*The enrollment plan above is based on total enrollment. However in budgeting for this proposed budget neutral program, an attrition rate of 10% was assumed. The budget plan also assumed that 80% of students would be enrolled part-time and 20% would be enrolled full-time based on current enrollment data in the MSN program.

Please indicate the anticipated first year and fourth year steady-state enrollment (head count) for the proposed program.

Year 1: Full Time ___6____ Part-time __14_ Total 20 (Post-master’s)

Year 4: Full-time ___51____ Part-time _119_ Total ___170___

III. PROGRAM REQUIREMENTS AND CURRICULUMA. Program Planning

1. List the names of institutions with similar offerings regarded as high quality programs by the developers of the proposed program.

1. Duke University 2. Gardner-Webb University 3. University of Alabama 4. University of Southern Indiana 5. Waynesburg University 6. St. John Fisher College 7. University of Oklahoma Health Sciences Center

2. List institutions visited or consulted in developing this proposal. Also discuss or append any consultants' reports or committee findings generated in planning the proposed program.

A DNP Task Force was convened to develop the proposed DNP curriculum. Members of the task force contacted several institutions such as University of Alabama, University of Southern Indiana, Duke University, Gardner-Webb University, University of Oklahoma Health Sciences Center and Waynesburg University. In addition, the task force reviewed the websites of additional programs accredited by CCNE. Content and specific courses were compared for similarities and for how the AACN DNP Essentials were being met. Dr. Mary Collins has agreed to serve as a consultant for the proposed DNP curriculum. She is the director of the DNP program at St. John Fisher College School of Nursing and also serves on the CCNE Standards committee. The CON will be sending materials for review in early August 2012.

B. Admission. List the following:

1. Admissions requirements for proposed program (indicate minimum requirements and general requirements).

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Adopted05/23/12Admission to the post-master's DNP program requires the student to meet the minimum admission requirements for graduate study of the university and the following requirements of the CON:

A master's degree in nursing from a nationally accredited nursing program

Current non-restricted license to practice as a registered nurse (RN) in NC or an NCSBN compact state

A one-page personal statement describing the applicant's interest in graduate study, career goals, and the certificate's relationship to those goals

Three professional references, with one reference from an individual who is knowledgeable of the applicant's nursing practice

One year clinical experience as an RN A personal interview with a member of the graduate CON

faculty

*Please Note:

For nurse anesthesia applicants: at least one year of adult critical care experience is required, a personal interview with the Nurse Anesthesia Admissions Committee will be conducted, an acceptable score on the GRE within the past five years is required, and four professional references and completion of a supplemental admissions packet are required.

For nurse-midwifery applicants: one year of RN clinical experience (labor & delivery preferred).

For neonatal nurse practitioner applicants: One year of full-time, recent practice experience in the care of critically ill newborns, infants, or children in an acute care, inpatient setting.

For clinical nurse specialist applicants: the student's transcript must reflect the completion of 4 graduate level clinical courses: Human Physiology for Advanced Nursing Practice (APN), Health Assessment for Advanced Practice Nursing, Health Promotion and Disease Prevention for Advanced Practice Nursing, and Clinical Pharmacology for Advanced Practice Nursing. If these courses have not been taken prior to admission they will be required by the concentration.

At the second year after establishment, the CON will begin transitioning students currently in the traditional MSN program for AGNP and FNP concentrations into the post-master’s curriculum as soon as they graduate with a master’s degree in nursing. In addition, ECU CON will accept its first cohort into the post-baccalaureate DNP program. The entry level degree for the BSN-to-DNP program will be a bachelor of science in nursing. Although initially the program will be focused on AGNP and FNP master’s preparation, as other clinical specialties mandate the DNP entry level, the traditional master’s program in those concentrations will be phased out and the post-baccalaureate-to-DNP program will enlarge.

2. Documents to be submitted for admission (listing or attach sample).Page 22 of 40


Adopted05/23/12

Eligible candidates for admissions will provide evidence of:

A master’s degree in an area of advanced nursing practice (nurse practitioner, clinical nurse specialist, nurse midwifery, or nurse anesthetist) from a regionally accredited institution;

Current professional certification as an advanced practice nurse;

A graduate grade point average of at least 3.0 overall (based on a 4.0 scale)

Three favorable completed references from persons who have knowledge of the applicant’s potential for success for graduate nursing studies and advanced practice nursing;

Evidence of a license as a (1) Registered Nurse and (2) Advanced Practice Nurse or eligibility in the state in which the applicant plans to practice.

Personal goal statement that is congruent with the program goals (300 words or less);

A personal interview by phone or in person

C. Degree requirements. List the following:1. Total hours required. State requirements for Major, Minor, General

Education, etc.

There are 36 semester hours required for ECU’s proposed post-master’s DNP degree. Students may choose to enroll in elective hours; no minor area is required. Once the program transitions to the post-baccalaureate DNP for FNP and AGNP students the total hours required will be 81 sh for AGNP and 86 sh for FNP students. As other advanced practice nurse specialties transition the hours will vary based on specialty area. Currently the hours required for the MSN degree for the specialties are as follows: AGNP—45 sh, FNP—50 sh, Clinical Nurse Specialist—42 sh, Neonatal Nurse Practitioner—41 sh, Nurse Anesthesia—68 sh, Nurse Midwifery—50 sh. Therefore, an additional 36 sh will be added to each plan of study as students transition to the DNP degree.

2. Other requirements (e.g. residence, comprehensive exams, thesis, dissertation, clinical or field experience, "second major," etc.).

A minimum of 1,000 practice hours must be acquired in the DNP program. For the post-master’s program, practice hours must be included; however clinical hours from the student’s MSN program can be counted for part of the 1,000 practice hour requirement. For example, ECU CON requires 728 clinical hours and AGNP requires 616 hours. Therefore, 272 additional hours would be required for FNP students and 384 hours for AGNP students while enrolled in the post-master’s curriculum. These hours include applied hours involved during the capstone project, which may or may not involve direct patient care. The 1000 hour requirement does not result in an extraordinary increase in clinical hours required, since the curriculum currently requires an extensive number of hours to meet credentialing and accreditation requirements.

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Adopted05/23/12There are a minimum of nine on campus dates required throughout the curriculum for skill development and evaluations with standardized patients in the BSN-to-DNP program. The post-master’s DNP curriculum will not require campus visits unless the student in pursuing a different specialty focus. The on-campus visits are another method to authenticate the identity of enrolled students.

A scholarly capstone project is a terminal requirement for the proposed DNP degree at ECU. The project will involve a core faculty member and one additional faculty or adjunct faculty member. A practice expert may be used from the institution where the project is being conducted. In addition, collaborative partners within the Health Science Division, as well as other parts of the university, will be useful to serve as committee members. The capstone committee will serve a mentoring role to assist the student as they conduct an evidence-based project.

For graduate programs only, please also list the following:3. Proportion of courses open only to graduate students to be required in

program

All courses in the post master’s DNP program and the BSN-to-DNP program are open to graduate students only.

4. Grades required

To meet the requirements for graduation and to remain in good academic standing, a student must demonstrate acceptable performance in course work after being admitted to a graduate or certificate program. This requires a cumulative 3.0 GPA in all course work.

In addition to the expectations for successful performance of course work described in the previous paragraph, good academic standing requires satisfactory progress in the overall graduate program. The student’s advisor or Graduate Advisory Committees may render judgments as to whether satisfactory progress is being made toward the degree, taking into account all aspects of academic performance and promise, not necessarily course work alone. A positive judgment is required to remain in good academic standing. For students involved in research-oriented programs, the student's department and individual advisory committee are responsible for evaluating the student's skills with respect to performing quality research. Failure to meet programmatic/departmental standards can result in termination from the program.

5. Amount of transfer credit accepted

Up to 20 percent of the credit hours in the DNP program can be earned in any regionally accredited college. Graduate-level course work taken elsewhere is not automatically applicable to a graduate degree program at East Carolina University. Applicants for admission must indicate clearly on application forms their attendance at other graduate-level institutions and petition college, school, or departmental advisors to apply such earned credits to their programs. College, school, or departmental petitions for application of transfer credit must be approved by the Graduate School. Ordinarily the Graduate School will

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Adopted05/23/12approve the application of graduate course transfer credit only if (1) the college, school, or department so recommends; (2) the graduate credit was earned at a regionally accredited institution; (3) the student was admitted to a formal graduate degree program at the time the credit was earned with a minimum final course grade of “B”; and (4) the credit can be satisfactorily incorporated within the applicable time frame for completion of all degree requirements. Official transcripts which will provide adequate evidence to support such petitions must be supplied.

Students who have been admitted to the Graduate School at East Carolina University may enroll at other regionally accredited graduate-level institutions for course work which is applicable to their programs provided they have obtained advance permission from their college, school, or graduate program director and the Dean of the Graduate School. Such transfer work is included in the 20 percent maximum application of such credit to degree programs. Transfer credit for short courses or workshops can be obtained only at the rate of 1 semester hour of credit for each calendar week of course attendance; concurrent enrollment in two or more short courses or workshops is not permitted.

6. Language and/or research requirements

There is no language requirement. Students are not required to complete a research project but are required to complete a scholarly project that involves an evidence base, a scholarly inquiry, a written paper about the inquiry, and a formal presentation of the findings.

7. Any time limits for completion

Similar to other graduate programs in the ECU Graduate School, there is a 6 year time limit for completion of the DNP degree.

D. For all programs, list existing courses by title and number and indicate (*) those that are required. Include an explanation of numbering system. List (under a heading marked "new") and describe new courses proposed.

Credit

Hours

CourseNumber DNP Courses New*

3 sh Pending *Design and Statistical Methods for Advanced Nursing Practice

Provides the student with the basis to research, retrieve, and manipulate statistical data. Focuses on quantitative methodologies, research design, and data analysis, providing essential knowledge for the evaluation of research to guide evidence-based advanced nursing practice.

3 sh Pending *Philosophical, Theoretical, and Conceptual Foundations of Advanced Nursing Practice

Analyzes and integrates the theoretical, philosophical and scientific underpinnings of nursing, organizational, biophysical, analytical,

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Adopted05/23/12

Credit

Hours


natural, and psychosocial sciences.

3 sh Pending *Population Health in Advanced Interdisciplinary Practice

Prepares the doctoral student to implement specialty population-based disease prevention and health promotion activities to achieve national and international goals of improving worldwide health status. Focuses on a spectrum of issues affecting health including emerging infectious diseases, emergency preparedness, disparities in health and healthcare services, and the impact of behavior and lifestyle choices.

3 sh Pending *Interdisciplinary Leadership and Role Development for Practice Excellence

Provides a comprehensive exploration of leadership principles and leadership techniques. Provides students with knowledge and skills for innovative leadership roles in autonomous and interdisciplinary practice systems and organizations.

3 sh Pending *Health Care Finance

Provides a working knowledge of selective financial and management control techniques with practical application within the interdisciplinary environment. Provides a broad introduction to important financial concepts, issues, tools, and vocabulary useful to healthcare leaders, clinicians, policy makers and administrators.

3 sh Pending *Health Care Policy, Politics, and Ethics

Prepares students to identify legislative, regulatory processes, and outcomes that influence healthcare policy. Explores the impact of Healthy People 2020 and the Institute of Medicine report objectives as they apply to the health care policy.

3 sh Pending *Application of Best Practices in Interdisciplinary Settings

Provides knowledge and skills essential to translate knowledge to clinical practice

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Adopted05/23/12

Credit

Hours


using innovation science and quality improvement research. Examines the applicability of research and evidence-based practice guidelines in an interdisciplinary organizational setting.

3 sh Pending *Informatics for Advanced Nursing Practice

Explores the development, use, and evaluation of computer systems for clinical practice, education, and shared clinical decision-making. Focuses on standards in terminology, data storage, and transmission; data capture, analysis, and application for quality improvement.

2 sh Pending *Scholarly Capstone Project I

Provides the advanced practice nurse the opportunity to acquire practical expertise in a practice setting. This practicum is individualized based on a contract negotiated among the Professor, student, and preceptor. The student will form a Scholarly Practicum Committee, develop a problem statement, objectives, project timeline, and evaluation strategies. This course is part one of a four semester sequence required of all DNP students.

3 sh Pending *Scholarly Capstone Project II

Focuses on project development including process and outcome evaluation, budget development, and measurement tools. The final full project proposal, including plans for scholarly presentation, will be completed during this course. This course is part two of a four semester sequence required of all DNP students.

3 sh Pending *Scholarly Capstone Project III

Focuses on implementation of the DNP project. This course is part three of a four semester sequence required of all DNP students.

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Adopted05/23/12

Credit

Hours


4 sh Pending *Scholarly Capstone Project IV

This course culminates the DNP scholarly practicum. Students will present their current project status, evaluation methodology, dissemination plans, and future recommendations. Dissemination of the project outcomes will be completed. Methods to address relevant Healthy People 2020 objectives will be included in the evaluation of this project. This course is the final course of a four semester sequence required of all DNP students.

36 sh TOTAL NUMBER OF REQUIRED HOURS

IV. FACULTY

A. (For undergraduate and Master’s programs) List the names, ranks and home department

of faculty members who will be directly involved in the proposed program. The official roster forms approved by SACS may be submitted. For Master’s programs, state or attach the criteria that faculty must meet in order to be eligible to teach graduate level courses at your institution.

Does not apply.

B. (For doctoral programs) List the names, ranks, and home department of each faculty member who will be directly involved in the proposed program. The official roster forms approved by SACS may be submitted. Provide complete information on each faculty member’s education, teaching and research experience, research funding, publications, and experience directing student research including the number of theses and dissertations directed.

Dr. Sylvia Brown, professor and dean, College of Nursing [email protected] 252- 744- 6372

Dr. Rebecca Benfield, nurse midwife, associate professor, and clinical researcher in pain and uterine contractility [email protected] 252- 744- 6459

Dr. Garris Conner, associate professor and director, neonatal nurse practitioner concentration [email protected] 252- 744- 6397

Dr. Martha Engelke, professor and associate dean for research and scholarship and Richard R. Eakin Distinguished Professor of Nursing [email protected] 252- 744- 6436

Dr. Elizabeth Jesse, nurse midwife, professor and clinical researcher in maternal depression [email protected] 252- 744- 6384

Dr. Carol Ann King, clinical assistant professor [email protected] 252-744-6452 Dr. Bobby Lowery, clinical associate professor and director, FNP/AGNP

concentration, [email protected] 252-744- 6363Page 28 of 40

mailto:[email protected]








Adopted05/23/12 Dr. Linda Mayne, associate professor [email protected] 252- 744- 6425 Dr. Maura McAuliffe, professor and director of the nurse anesthesia

concentration [email protected] 252- 744- 6443 Dr. Jana Pressler, professor and associate dean for graduate programs

[email protected] 252- 744- 6473 Dr. Mary Ann Rose, professor and chair, Department of Graduate Nursing

Science [email protected] 252- 744- 6437 Dr. Elaine Scott, associate professor and director of the East Carolina Center for

Nursing Leadership [email protected] 252- 744- 6383 Dr. Susan Williams, associate professor and director, clinical nurse specialist

concentration [email protected] 252- 744- 6472 Dr. Carol Winters, professor and director of the nursing education concentration

[email protected] 252-744- 6505

**See also the Biosketches attached for education, teaching and research experience, research funding, publications, and experience directing student research including the number of theses and dissertations directed.

C. Estimate the need for new faculty for the proposed program over the first four years. If the teaching responsibilities for the proposed program will be absorbed in part or in whole by the present faculty, explain how this will be done without weakening existing programs.

Initially there will be 3 FTE devoted for the post-master’s DNP program. Seven faculty will be teaching the initial courses as described in the aforementioned table. In addition, other faculty will be participating in working with students in the scholarly capstone courses as they conduct a scholarly project. As the enrollment expands to include BSN-to-DNP students the FTE will grow to nine FTE in year 5. Although the UNC funding formula generates more positions for a program of this size, the ECU CON faculty recognize that ECU is experiencing challenging economic times and therefore will manage to offer the program with only two additional faculty lines that have been committed by the vice chancellor for health sciences. There are 47 faculty who teach one or more courses in the current MSN curriculum. The CON currently has twenty-seven advanced practice nurses on faculty who are engaged in teaching the current MSN students in the advanced practice specialties and/or are engaged in clinical practice. The following faculty are advanced practice nurses: Bagley, Lowery, McAuliffe, Adams, Bolin, Brinsko, Dewees, Edge, Fell, Feyh, Green, Harrington, Haynes, Jesse, Jnah, A. King, P.King, Kosko, Lancaster, Mallette, Powell, Reardon, Reis, Roberson, Skipper, Spain, and Tillman. Six faculty members have recently obtained the DNP degree (Drs. Feyh, Harrington, P. King, Powell, Sigmon, and Woody) and three additional faculty are currently pursuing the DNP degree (Bagley, S. Cherry and Skipper). The DNP-prepared faculty will be mentored by CON senior faculty to prepare them for teaching in the DNP program. The CON has 42 faculty members with graduate faculty status, with additional faculty to be added requesting graduate faculty status in fall 2012. All of these faculty will be engaged in working with students as they progress to the capstone projects and will assist in teaching BSN-to-DNP students throughout the curriculum.

The program planners recognize that enrollment increase funds will not likely be available. Because of the high priority of this program ECU is willing to commit some resources to its implementation. Once the program is approved, the CON will actively seek external funding through grants. If additional

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Adopted05/23/12resources are not secured, reallocation of current resources and consideration of decreasing enrollment in other nursing programs may become necessary.

D. Explain how the program will affect faculty activity, including course load, public service activity, and scholarly research.

Faculty Activity. Faculty members have expertise in online teaching/learning formats and are supported by a very knowledgeable and skilled technology team. Even though the DNP program will be offered online, it will require additional resources in terms of hours required of the support staff. The CON will utilize the current workforce in terms of administrative support, IT support, and clinical coordination in order to implement and maintain the program requirements.

Course Load. Current faculty members have planned this program and are continuing to develop the curricula, but are already being fully utilized in current programs within the CON. In order to begin the DNP program, additional faculty would be required. These additional faculty members would initiate the program, admit the first cohort of students, and teach the initial classes. As the demand for the BSN-DNP program develops, existing faculty members currently teaching in the MSN program would transition to the BSN- DNP program. The expectation of the faculty is that the master’s programs in the advanced practice concentrations would eventually be eliminated as the faculty transition to BSN-DNP; however, the CON would continue to offer the MSN degree for students whose focus area of study is nursing education or nursing leadership.

Public Service. Current faculty members may need to reduce some public service commitments. However, the DNP program per se is not expected to deter any one faculty member’s public service significantly.

Scholarly Activity. Current faculty members will experience some additional work with their involvement with the DNP program and need to be both selective and sensitive with planning their time. The faculty most affected by the new program will be those who are tenured and fixed term faculty. Tenure track faculty are given teaching assignments that allow them more time for research and scholarly activity.

V. LIBRARY A. Provide a statement as to the adequacy of present library holdings for the

proposed program to support the instructional and research needs of this program.

The Laupus Health Sciences Library (HSL) is a high quality comprehensive health sciences library serving the Division of Health Sciences at East Carolina University and is housed in the same building as the CON. The Library occupies 72,000 square feet and welcomed 144,000 patrons through its doors in fiscal year 2011-12. The HSL makes a great effort to reach out to patrons in online courses. Distance Education services include email, chat and phone reference assistance, online databases and full-text journals access, web-based instructional tutorials, and Document Delivery services where materials are sent online or in the postal mail to students at a distance.

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Adopted05/23/12A full-time HSL librarian prepared at the master’s level is assigned as liaison to the College of Nursing. This librarian has a command of the nursing literature and serves as a resource for faculty and students in the College. Although not a nursing faculty member, the liaison is embedded in the College processes. For example, the liaison attends nursing faculty organization meetings and the general student orientation sessions at both graduate and undergraduate levels. In addition, the liaison provides a rather extensive orientation to online education for DE graduate students.

Last academic year, the CON library liaison assisted faculty with the development of an online orientation program which is now required of every student enrolling in the graduate program. It teaches needed skills such as how to do online searches of the data bases, how to avoid plagiarism, how to navigate Blackboard, etc. Students are required to take the tutorial course prior to being allowed to open Blackboard for the first course.

The liaison also is available for special faculty sessions; upon our request the liaison gave a presentation for the Graduate Nursing Sciences Department on the recent changes in APA format and one on copyright law. The liaison often comes to individual nursing faculty offices for one-on-one consultation and is often asked to assist with setting up online literature alerts or other types of searches.

Nursing resources are a core part of the HSL collections. The Library subscribes to major databases such as Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest Nursing and Allied Health Source, Nursing and Allied Health Collection: Comprehensive, and Mosby’s Nursing Consult. It carries publisher journal packages and historical back files from LWW, Mary Ann Liebert, Science Direct and Wiley-Blackwell which are heavy with nursing research. Laupus also licenses the skills-based resource Mosby’s Nursing Skills, and RefWorks, which allows students to organize and format references and research papers. The library supplies access to more than 95,900 full text electronic journal titles; has a current circulating print and e-book collection of 319,200 titles, 3,831 fall within the nursing call number range and 21electronic resources available on or off-campus with nursing-specific information. The present library holdings for the proposed program will be excellent support for both instructional and research needs of this program.

B. State how the library will be improved to meet new program requirements for the next four years. The explanation should discuss the need for books, periodicals, reference material, primary source material, etc. What additional library support must be added to areas supporting the proposed program?

No additional library support will be needed to support the proposed program. The resources available for ECU’s BSN, MSN, and PhD programs will also be adequate to support the DNP program.

C. Discuss the use of other institutional libraries.

The Outreach Services Department of the Laupus Library, in conjunction with the Office of Eastern AHEC provides support and training for information systems and technology to primary care physicians, mid-level practitioners and health sciences students in community-based teaching and practice sites within the 23-county Eastern AHEC region. Specific services include facilitating document delivery services, reference searches, and database

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Adopted05/23/12training. Remote access to databases is available to eligible health professionals through the Outreach Services Department, and through the statewide AHEC Digital Library. In addition to Laupus Health Sciences Library and the AHEC Digital Library, ECU students who live away from the campus, or are travelling within NC, may take advantage of the cooperative borrowing agreement established among the University of North Carolina system of schools. This allows all ECU students to directly borrow and utilize materials from any of the other 16 UNC system libraries.

VI. FACILITIES AND EQUIPMENT

A. Describe facilities available for the proposed program. The ECU CON is located in an 84,000 square foot facility that was opened in 2006. The state-of-the-art facility is complete with eight concept integration laboratories hosting multiple levels of simulation technology, 12 classrooms equipped with SMART Classroom Technology, 124 offices, and indoor access to the adjoining 63,000 square foot Laupus Health Sciences Library. Classrooms vary in shape and configuration, with several spaces, including all labs, utilizing free standing furniture which may be configured according to instructional needs. All faculty and staff members are provided office space, desktop computers which are replaced on a three-year cycle and loaded with the most current versions of MS Office, and other software as needed by each individual such as SPSS, Nvivo, Adobe Creative Suite and others. Additional web access to a comprehensive list of software titles is available through the ECU Onestop IT system.

B. Describe the effect of this new program on existing facilities and indicate whether they will be adequate, both at the commencement of the program and during the next decade. The CON has adequate facilities to accommodate the needs of the proposed program. The DNP program will be conducted online; therefore, space for classrooms and other activities will be limited. When the program transitions to the BSN-to-DNP, the specialty courses require a limited number of on-campus experiences for clinical skill development which is accommodated in the current concept integration labs. No additional specialized equipment will be needed. Office space is available for any new faculty hires.

C. Describe information technology and services available for the proposed program.

The ECU CON has a strong, internal technology team to support its DE activities. The college’s technology team is composed of experienced IT professionals with a wide range of training and expertise. They provide immediate support for all the college’s DE activities. This support includes instructional technology consulting for DE course development/delivery, and training on/assistance with a wide array of available DE technical tools. The university also provides DE instructors with many excellent technical resources, such as Blackboard, Centra, Mediasite, etc. The college’s IT team manages those resources at the unit level, offering training workshops and personal assistance to instructors. The ECU CON IT team also provides

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Adopted05/23/12hardware/software troubleshooting, repair and configuration for instructor workstations and mobile devices.

The faculty and CON IT team have developed the Virtual Community Clinic Learning Environment (VCCLE) as an online virtual reality trainer which is designed to develop competency-based critical thinking skills in nursing students. The VCCLE is a web-based, asynchronous, immersive clinic environment into which nursing students enter to meet and interact with instructor-controlled virtual patient and preceptor avatars. In the VCCLE, with virtual preceptor guidance, students interview patients and move through a classic diagnostic sequence to arrive at a diagnosis, impression, and plan of care for each patient. The VCCLE has proven to be an excellent, innovative resource for advanced practice nurse students thus far, in both distance education programs and training for practicing in other cultures and regions. Since it is asynchronous, distance education students are able to work their cases when convenient for their schedule. Also, while traditional clinical training is limited to a specific location with patients and pathologies typical to that local environment, the VCCLE enables instructors to transcend physical practice boundaries and present students with culturally and ethnically diverse patients and patient cases expressing conditions endemic to a specific environment. The virtual clinic is a valuable augmentation of the on-site training that occurs in the practice setting.

D. Describe the effect of this new program on existing information technology and services and indicate whether they will be adequate, both at the commencement of the program and during the next decade.

The ECU CON technology support team is well equipped to support new programs and meet new support requests. With years of experience adapting to the dynamic DE technical landscape, the college’s IT team has developed a robust support framework, with firmly established change protocols. Also, the college’s IT team contains a group of excellent programmers/software developers. This personnel asset enables the support team to work “outside the box” and develop custom solutions to meet unusual support challenges, or augment existing resources to meet special circumstances. The ECU CON technical support team also has an excellent relationship with the university IT support organization. These considerable technical attributes form a strong support foundation, well positioned to technically assist with the beginning of any new program, and able to adapt and meet any challenges necessary to guarantee future success.

VII. ADMINISTRATIONDescribe how the proposed program will be administered, giving the responsibilities

of each department, division, school, or college. Explain any inter-departmental or inter-unit administrative plans. Include an organizational chart showing the "location" of the proposed new program.

The current director of the FNP and AGNP concentrations in the MSN program, Dr. Bobby Lowery, will serve as the Director of the DNP program during its start-up phase. He will report to Dr. Jana Pressler, Associate Dean for Graduate Programs, who provides oversight for all graduate programs in the CON. Dr. Pressler has directed a DNP program at another university. The associate dean reports to the Dean of the CON.

VIII. ACCREDITATION AND LICENSUREPage 33 of 40


Adopted05/23/12A. Indicate the names of all accrediting agencies normally concerned with programs similar to the one proposed. Describe plans to request professional accreditation.

The ECU CON is accredited by the Commission on Collegiate Nursing Education (CCNE), the leading accrediting agency for baccalaureate and higher degree nursing programs in the U.S. CCNE and the National League for Nursing Accreditation Commission are the two accrediting bodies that accredit DNP programs. The CON has notified CCNE of its intent to establish a DNP program and is using these guidelines to prepare the DNP curriculum. CCNE has responded that the CON must submit a substantive change notification 90 days prior to program implementation. The CON is scheduled for a review of the BSN and MSN programs in fall 2014. CCNE will review the DNP program as well if approved and implemented by fall 2013.

B. If the new degree program meets the SACS definition for a substantive change, what campus actions need to be completed by what date in order to ensure that the substantive change is reported to SACS on time?

Chancellor Steve Ballard informed SACS on June 28, 2012, that The University of North Carolina Board of Governors has authorized East Carolina University to plan a doctor of nursing practice degree. It was noted that the CON plans to deliver the degree in an online format. The university has indicated that it is prepared to provide SACS with preliminary documentation should the offering of the DNP be deemed a substantive change for ECU and is awaiting a response.

C. If recipients of the proposed degree will require licensure to practice, explain how program

curricula and title are aligned with requirements to “sit” for the licensure exam.

The DNP program will initially begin as a post-master’s DNP program. Students in the program will already be licensed to practice and credentialed as an advanced practice nurse. When the program transitions to the BSN-to-DNP, processes are in place to assure that students meet all requirements for credentialing as an advanced practice nurse. These processes are in place currently for students in the advanced practice specialties in the MSN program. Graduates achieve above the national average on first time pass rates on national certification exams.

IX. SUPPORTING FIELDSAre other subject-matter fields at the proposing institution necessary or valuable in support of the proposed program? Is there needed improvement or expansion of these fields? To what extent will such improvement or expansion be necessary for the proposed program?

Several disciplines within the university can serve as additional support for the proposed programs. The College of Health and Human Performance, the College of Human Ecology, The Thomas Harriot College of Arts and Sciences, the School of Education, and the colleges/schools within the Health Science Division have supportive fields of study that can enhance student learning in this program, including the doctoral program in physical therapy and the post-graduate programs in the Brody School of Medicine.

X. ADDITIONAL INFORMATION

Include any additional information deemed pertinent to the review of this new degree program proposal.

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Adopted05/23/12

No additional information.

XI. BUDGETBased upon your responses in previous sections, provide estimates of the

incremental continuing and one-time costs required to implement the proposed program.

A. Estimates should be provided for the first and fourth years of the program in the following broad categories and be inclusive of applicable employee fringe benefit costs:

1. New Faculty and Instructional Support Staff (including Library) - Although the CON has a group of faculty who have developed this proposal and will be prepared to teach in the DNP program, two additional faculty members will be required to establish the program. Although the UNC funding formula generates additional positions for a program of this size, the faculty recognizes the difficult economic times and will manage with only two additional faculty lines which have been committed by the Vice Chancellor for Health Sciences. The CON will require three faculty fte in year one with a total cost of $338,820 for salaries, benefits, taxes, and insurance. In year four the requirements will increase to nine faculty fte with a total cost of $980,449 for salaries, benefits, taxes, and insurance.

2. New Non-Academic Administrative Support Positions - Even though the DNP program will be offered online, it will require additional resources in terms of hours required of the support staff. The CON will utilize the current workforce in terms of IT support in order to implement and maintain the program requirements. The CON will reallocate the current staff supporting our ANP/FNP program in order to support the DNP program. This will add an additional administrative support staff in year one with a total cost of $50,823.60 for salaries, benefits, taxes, and insurance. In year four there will be a need for the administrative support staff and a clinical coordinator for a total cost of $104,062.60 for salaries, benefits, taxes, and insurance

The total cost of salary, benefits, taxes, and insurance for the DNP program for both faculty and staff is $3,322,383.90. Of these costs, 100% will be paid for by the University through the reallocation of existing resources with no additional funds being requested. The breakdown of the costs associated with salaries and benefits for faculty and staff for years one and four is as follows:

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Year 1 Year 4

Salaries$308,000.0

0$858,000.0

0Social Security $23,562.00 $65,637.00State Retirement $38,357.60 $106,633.6

0Medical Insurance $19,724.00 $54,241.00

Total$389,643.6

0$1,084,511.

60


Adopted05/23/12These totals are based on three faculty fte and one administrative support staff for year one and nine faculty fte, one administrative support staff, and one clinical coordinator in year four based on enrollment projections.

3. Recurring Operational Expenses (e.g., supplies, materials, telephone, travel, insurance, library or software subscriptions, equipment maintenance, etc.) - Recurring operational expenses will total $132,500 for years one through four and will include $63,000 in faculty development and travel; $8,500 in supplies; $20,000 for contract services such as outside clinical service fees, evaluation fees in year 2, lab fees, and certification fees; $41,000 for faculty recruitment, marketing, and advertising. These expenses will also be paid for through reallocation of existing resources.

4. One-time expenses for facilities renovations or additions, equipment purchases, library materials, etc. - One-time expenses for years one through four total $73,500. These expenses will include the cost of equipment and technology used to start and maintain the program. $6,000 of this will be earmarked for a virtual server that will be requested in year 2.

B. Based on the campus’ estimate of available existing resources or expected non-state financial resources that will support the proposed program (e.g., federal support, private sources, tuition revenue, etc), will the campus:

1. Seek enrollment increase funds or other additional state appropriations (both one- time and recurring) to implement and sustain the proposed program? If so, please elaborate.

As previously noted, the program planners recognize that enrollment increase funds are not likely to be available. Because of the high priority of this program ECU is willing to commit some resources to its implementation. The current director of the FNP and AGNP concentrations in the MSN program, Dr. Bobby Lowery, will serve as the Director of the DNP program during its start-up phase. He will report to Dr. Jana Pressler, Associate Dean for Graduate Programs, who provides oversight for all graduate programs in the CON. The associate dean reports to the Dean of the CON. This lessens the need for additional faculty. As vacancies occur, we will recruit faculty with DNP preparation. Two FTEs have been committed to the program by the Vice Chancellor for Health Sciences. Finally, initial enrollment projections were revised downward and plans to move directly to the post- baccalaureate-to-DNP program were accelerated in order to accommodate the students without addition of new resources.

2. Require differential tuition supplements or program-specific fees? If so, please elaborate.

a. State the amount of tuition differential or program-specific fees that will be requested.

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Adopted05/23/12The CON is requesting a tuition surcharge of $100/credit hour for all resident and non-resident MSN students to be effective in the 2013-14 school year. Students who are currently enrolled in the MSN program would not be affected this year but would incur the charge beginning in 2013. We do not anticipate that this will result in a significant decline in enrollment. In order to maintain consistency with other graduate programs at the university, such as the MBA and MSA programs, the college would prefer to request the increase on a per credit hour basis. We also request that the DNP credit hours have a tuition surcharge of $100/credit hour.The tuition for MSN students at ECU is the least expensive in the state supported schools. As a comparison, the UNC Board of Governors approved a tuition increase for FY 2012-13 of $3,257 for UNC-Chapel Hill’s MSN tuition (from $7,877 in 2011-12 to $11, 134 in 2012-13). The current tuition and fees for MSN students at ECU is $2,786.50. The proposed surcharge would increase tuition by $2600 for the first year (fall, spring and summer) for year one of the post-master’s DNP program for a student enrolled full-time. Between fall 2010 and summer 2011, there were 236 master’s level courses with a total of 8,137 generated credit hours. If the increase were approved, this would generate approximately $813,700 in additional revenue for the CON. Typically 20% - 40% of this revenue is allocated to student financial aid, which would leave a net gain to the CON of $488,220 - $650,960.

b. Describe specifically how the campus will spend the revenues generated.

The additional revenue will be used to support need-based financial aid and recoup some of the costs of offering graduate clinical programs such as clinical site placements, meeting clinical agency requirements for safety and legal compliance, maintaining a high fidelity simulated learning laboratory, and recruiting and retaining faculty to teach in graduate clinical programs. The tuition surcharge would fund five to six faculty FTE, as well as provide additional funding for DNP students.

c. Does the campus request the tuition differential or program-specific fees be approved by the Board of Governors prior to the next Tuition and Fee cycle?

Hopefully the tuition differential will be approved prior to the next Tuition and Fee cycle. The additional revenue would support DNP program growth in critical areas, such as a need for additional faculty to support the scholarly projects of DNP students. This need will arise as early as the second year of the program when post-master’s students would be fully engaged in these projects.

C. If additional enrollment increase funding or other state appropriations elaborated above are not forthcoming, can the program still be implemented and sustained and, if so, how will that be accomplished? Please elaborate.

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Adopted05/23/12

The program planners recognize that enrollment increase funds are not likely to be available. Because of the high priority of this program ECU is willing to commit some resources to its implementation. Among those resources is funding generated by ECU’s clinical faculty who do clinical practice out in the field and generate revenue that comes back to the CON through an established practice plan.

As the faculty members are awaiting permission to implement the program they will begin preparation of grants to Health Resources and Services Administration (HRSA) and other relevant federal and state agencies requesting additional funding. Such grants may be submitted when the program has received approval. Such funding can be used to subsidize faculty salaries and to support faculty and doctoral student travel to professional meetings. Funds would be requested in addition to enhance minority recruitment for the program, develop additional practice sites in rural eastern NC, and enhance the cultural competency of the faculty. The CON has been successful in generating such grants in the past for the advanced practice master’s programs and anticipates that this program would be attractive to such funding agencies in the future as well. In addition, the CON traditionally receives approximately $120,000 per year in traineeship funds from HRSA for master’s and doctoral students; approximately one - third ($40,000) will be made available to help support students in this program.

The last resort if funding is not received in the manner mentioned above would be to decrease the enrollment in the program or reallocate resources from other program areas to ensure appropriate implementation and sustainability.

XII. EVALUATION PLANSA. Criteria to be used to evaluate the quality and effectiveness of the program,

including academic program student learning outcomes.

The criteria for evaluating the quality and effectiveness of the DNP will be both formative and summative in nature. Formative evaluation enables faculty to ensure or validate that the specific goals of instruction are being achieved during the course of the program and to make adjustments to instruction as needed. Summative evaluation examines desired student learning outcomes to ensure that the program’s goals and objectives are being met. Additionally, as a program within the CON, the DNP is subject to rigorous standards of program evaluation which include annual assessment of structure, function, process, and outcomes. Graduation and retention data are maintained to demonstrate timely progression. Established standards for number, diversity and quality of students admitted are carefully monitored to ensure that state and regional needs for these professionals are met.

B. Measures (metrics) to be used to evaluate the program (include enrollments, number of graduates, and student success).

The formal process of evaluation at the CON includes collection, recording, and reporting of numbers of applicants and enrollments on an annual basis. Cohorts of students are established upon admission to track retention and graduation rates. Each program within the college is responsible for

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Adopted05/23/12developing an assessment of student learning plan, which includes objectives, measures, outcomes, and a plan of action. These plans are maintained using the University’s web based system, TracDat, and monitored by the Office of Program Evaluation within the college. This system ensures access to accurate, timely data that can inform decision.

Professionally, evaluation of the DNP is guided by ‘The Essentials of Doctoral Education for Advanced Nursing Practice’. This document, published by the American Association of Colleges of Nursing (AACN, 2010) outlines the curricular elements and competencies that must be present in programs conferring the Doctor of Nursing Practice (DNP) degree. The document delineates eight DNP Essentials of foundational outcome competencies. The summative component of evaluation of the DNP program at ECU CON will include assessment of the eight essentials through the administration of the Educational Benchmarking, Inc. (EBI) DNP Exit Assessment survey. This survey, designed in conjunction with AACN, has 130 items and assesses several factors of DNP education including quality of faculty and instruction, administration and academic advising, and learning outcomes with respect to nursing science, science-based theories, health care diversity, etc. The AACN/EBI Exit Assessment survey will be administered with the first, and every succeeding, graduating class.

C. The plan and schedule to evaluate the proposed new degree program prior to the completion of its fourth year of operation.

During the formative stages of evaluation each course, or course groupings, will assess student learning through the use of rubrics and other established evaluative tools. The results will be compiled and shared with faculty and program staff at regular intervals, approximately every six months, such that the results can be used promptly and effectively to improve program quality. Summative evaluation will occur annually as part of the CON Evaluation Plan. Finally, within a year of program implementation, ECU CON will seek accreditation of the DNP program by The Commission on Collegiate Nursing Education (CCNE), the accreditation component of AACN. CCNE accreditation acknowledges the program’s compliance with the “Essentials,” and its commitment to continuous quality improvement in program design, delivery, and student outcomes.

XIII. REPORTING REQUIREMENTSInstitutions will be expected to report on new program productivity as a part of the biennial low productivity program review process.

This proposal to establish a new degree program has been reviewed and approved by the appropriate campus committees and authorities.

Chancellor: ________________________________________Date:___________________

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Adopted05/23/12References cited

American Association of Colleges of Nursing (2004). AACN position statement on the practice doctorate in nursing. www.aacn.nche.edu/publications/position/DNPpositionstatement.pdf

Boston, D. (2008). Poverty rates in North Carolina. Where do the poorest Americans in the state live? www.suite101.com/content/poverty-in-north-carolina-a61122

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2012-13 Edition, Registered Nurses. www.bls.gov/ooh/healthcare/registered-nurses.htm ECU Tomorrow: A Vision for Leadership and Service. http://www.ecu.edu/cs-admin/mktg/ecu_tomorrow/our_strategic_directions.cfm

Expanding Access to Health Care in North Carolina: A Report of the NCIOM Health Access Study Group. (2009). www.nciom.org/wpcontent/uploads/NCIOM/projects/access_study08/HealthAccess_FinalReport.pdf Institute of Medicine of the National Academies. (2010). The Future of Nursing: Leading Change, Advancing Health. Focus on Education Report Brief. www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx/

National Research Council. Health Professions Education: A Bridge to Quality. Washington, DC: The National Academies Press, 2003.www.nap.edu/openbook.php?record_id=10681&page=1

NC State Center for Health Statistics. (2010). www.schs.state.nc.us/SCHS/

Practice Doctorate Nurse Practitioners Entry-Level Competencies (2006). http://www.nonpf.org/associations/10789/files/DNP%20NP%20competenciesApril2006.pdf

University of North Carolina Tomorrow: Leading, Connecting, Transforming (2007). www.northcarolina.edu/nctomorrow/about/index.htm

ATTACHMENTS

Attachment A: Letter of Support from Vice Chancellor for Health Sciences Attachment B: UNC-Wilmington MOUAttachment C: UNC- Pembroke Letter of SupportAttachment D: DNP EssentialsAttachment E: Faculty Information SheetsAttachment F: Organizational ChartAttachment G: Letter of Support from Dean Brown

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http://www.northcarolina.edu/nctomorrow/about/index.htm



http://www.schs.state.nc.us/SCHS/

http://www.nap.edu/openbook.php?record_id=10681&page=1

http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx/

http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx/

http://www.nciom.org/wpcontent/uploads/NCIOM/projects/access_study08/HealthAccess_FinalReport.pdf

http://www.nciom.org/wpcontent/uploads/NCIOM/projects/access_study08/HealthAccess_FinalReport.pdf

http://www.ecu.edu/cs-admin/mktg/ecu_tomorrow/our_strategic_directions.cfm

http://www.bls.gov/ooh/healthcare/registered-nurses.htm

http://www.suite101.com/content/poverty-in-north-carolina-a61122

http://www.aacn.nche.edu/publications/position/DNPpositionstatement.pdf