Facilitators and Barriers to Doctor of Nursing Practice Nurse Practitioner Program Implementation: A Mixed Methods Study.

Abstract

Background: Financial challenges can prevent the Doctor of Nursing Practice (DNP) from being offered to nurse practitioners (NPs). Objective: This study explored financial facilitators and barriers to implementing DNP-NP programs. Methods: An explanatory, sequential, mixed methods design was used. Full inclusion criteria required implementing a DNP-NP program after 2015 and creating a transition budget. Results: Of 119 respondents, 49 schools implemented a DNP-NP program; 70 schools never attempted implementation. Seventeen schools met full inclusion criteria, of which seven met financial projections. Dean's support was the most important contributor to meeting financial projections, while budget concerns were the anticipated primary contributor to schools not implementing a DNP-NP program. Low enrollment was the top-ranking barrier in all schools that implemented a DNP-NP program. Three focus groups and two structured interviews (n = 9) were conducted. Three important themes emerged for DNP-NP program implementation: financial factors, curriculum delivery, and external influences. Conclusions: Facilitators of budget-neutral or income-generating DNP-NP programs include support of administration, faculty and clinical partner collaboration, integrative curricular delivery, and staged transitions from Master of Science in Nursing NP programs. Implications for Nursing: Given the challenging financial environment of higher education, this work informs the successful implementation of DNP-NP programs.