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Nursing Organizational and Systems Leadership Discussion

Nursing Organizational and Systems Leadership Discussion

Nursing Organizational and Systems Leadership Discussion

Application of the DNP Essentials I-IV to your CSP.

Please respond to these five discussion board posts with substantive responses. the 5 responses will be 5, do not combine them into one post, they have to be five total with at least one reference for each.


The clinical scholarly project (CSP) is regarding the novice nurse practitioner’s role transition. The title of the CSP project is Improving Confidence Among Novice Nurse Practitioners Through a Role Transition Support Intervention. The scholarly project aims to offer a role transition webinar to novice nurse practitioners (NP) in California and explore its effectiveness in improving the NPs’ confidence in their new advanced practice role. DNP Essentials I-IV will tackle what applies to the project in this discussion.

Essential I: Scientific Underpinnings for Practice

The first essential consist of the foundation integrated into the DNP program. It shows that the conceptual foundation of nursing practice plays a big role in meeting the demands of practice environments. The DNP project will adapt “Limbo to Legitimacy” by Brown and Olshansky (1998) as its theoretical foundation and conceptual framework. It is a longitudinal qualitative study and research-based model which explores the ideas of professional development of novice NPs in the first year of practice (Thompson, 2019). It shows the complex changes that occur in four distinct stages, with each step having individualized emotional tasks and developmental challenges that are essential to legitimizing the NP (Thompson, 2019). As DNP students, we are prepared to use science base theories and concepts to determine the significance, enhance strategies and evaluate outcomes of health care delivery. DNP students are also developing and practicing new approaches based on nursing and other theories.

Essential II: Organizational and Systems Leadership for Quality Improvement and

Systems Thinking

The second essential discusses leadership to improve outcomes. It includes patient safety, health disparity elimination, and excellence in practice. The DNP project plays a role in the primary role shortage and the high turnover of nurse practitioners. The Association of American Medical Colleges (AMCC) (2019) noted that the United States would have a primary care provider shortage of 21,100 to 55,200 in 2032. Such increasing demand results from the growing elderly population in the country. To meet this demand, the US has empowered nurses to take primary care roles in the form of NPs. However, the attrition rate among NPs remains high. According to the Bureau of Labor Statistics (2015), in 2015, the turnover rate among NPs was twice higher than physicians. The project specifically addresses the issue of preparing nurse practitioners as these providers fill the gap since they can provide high-quality and cost-effective services. The Nurse Practitioner acts as a valuable resource in professional, clinical, and leading teams (Raftery, 2016).

Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based


The third essential is related to evidenced-based practice enhancement. According to Hassanian et al. (2015), knowledge is created from the information converted through mental processes, individual and group reflection, praxis, and research. The outcome of creating a piece of new knowledge is gaining new knowledge like creating a conceptual model and defining new roles. Other significances of knowledge creation include changes in procedures and activities and finding new solutions to existing problems. The DNP project includes the process of appraising existing literature that is related to role transition. There has only been one study that shows online intervention increases the confidence of the novice nurse practitioner. This project will gather data to prove that online intervention support will increase the confidence of the new nurse practitioners. The webinar came from evidence-based data and will examine confidence outcomes.

Essential IV: Information Systems/Technology and Patient Care Technology for the

Improvement and Transformation of Health Care

The fourth and final essential for this discussion calls to apply technology and information in changing and enhancing patient-centered health care. Trained advanced practice nurses are receptive to novel ideas, practices, and technologies, and they champion supporting and improving patient care and using data and technology. These trained nurses also distinguish that technology is integral to the organization’s critical processes (The American Association of Colleges of Nursing, 2006). The DNP Essential IV is vital to the DNP project due to using an online intervention to raise the knowledge and confidence of new graduate NP for the transition of their new role. This DNP project will utilize a webinar to assist novice NPs transitioning from school to clinical practice. Substantial evidence supports the benefits of webinars in improving the knowledge and skills of learners. For example, webinars improved students’ and professionals’ scores compared to those who did not receive any training (Gegenfurtner & Ebner, 2019). To summarize, the DNP Essentials I-IV is linked to this project regarding the nurse practitioner role transition, limbo to legitimacy theory, the NP’s role on provider shortage, and using a webinar as an online support intervention.


American Association of Colleges of Nursing (2006). The essentials of doctoral education

for advanced nursing practice.…

Association of American Medical Colleges (2019). New findings confirm predictions on physician shortage.

Brown, M., & Olshansky, E. F. (1997). From limbo to legitimacy: A theoretical model of the transition to the primary care nurse practitioner role. Nursing Research, 46(1), 46-51.

Bureau of Labor Statistics (2015). Job openings and labor turnover – June 2015. US Department of Labor.

Gegenfurtner, A. & Ebner, C. (2019). Webinars in higher education and professional training: A meta-analysis and systematic review of randomized controlled trials. Educational Research Review, 28, 100293.

Hassanian, Z. M., Ahanchian, M. R., Ahmadi, S., Hossein Gholizadeh, R., & Karimi-Moonaghi, H. (2014). Knowledge creation in nursing education. Global Journal of Health Science, 7(2), 44–55.

Raftery, C. (2016). The Role of Nurse Practitioners in Interdisciplinary Education.

The Journal for Nurse Practitioners,12(7), 495.

Thompson, A. R. (2019). An educational intervention to enhance nurse practitioner role transition in the first year of practice.

Journal of the American Association of Nurse Practitioners, 31(1), 24-32.


DNP Essentials I-IV

In 2004, the American Association of Colleges of Nursing (AACN) voted to endorse that DNP is the most appropriate entry to practice degree for advanced practice registered nurses in the United States (AACN,2004). Its curricula provide full content in evidence-based practice, quality improvement, and systems leadership.

As DNP-prepared nurses, we are well equipped to fully implement most of the sciences developed by nurse researchers prepared in many areas. Furthermore, the DNP essential has all the foundational competencies that are needed. Therefore, my CSP will demonstrate all the eight DNP essentials.

Essential I: Scientific Underpinnings for Practice

DNP graduates acquire a wide range of knowledge gathered from the sciences and can translate all this knowledge quickly and effectively to benefit the daily demands of the practice environment (AACN,2004). This CSP will provide a standard and more sustainable means of diabetes self-management on medications adherence in diabetes patients. It will incorporate essential 1 with a search for literature review to obtain evidence-based articles that support CSP. It will integrate nursing science with knowledge from ethics, the biophysical, psychosocial, analytical, and organizational sciences as the basis for the highest level of nursing practice.

The respect for autonomy, respect for persons, and self-determination provide individuals with the right to participate or not to participate in this CSP as a human subject. The critical element in this CSP is informed consent, to respect participant right to participate or not to participate. All the participants will be given informed consent as indicated in the researcher participant bill of rights. These documents outline the participants’ rights and explain the risk involved, that their participation is voluntary and that they may opt-out at any time, and procedures and protocols for maintaining confidentiality during the study.

Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking.

Health professionals need to make quality Improvement and Systems thinking a part of everyone’s job to achieve system change. This CSP offers a robust and practical approach in addressing real-life problems (diabetes), in real-life situations, and in real-time. This CSP will use improvement science methods and tools, not just to analyze but also to outline gaps in the quality of care, monitor the quality and reliability processes and the outcomes of care, test, design, and implement changes by using Medisafe medication reminder apps to continuously improve patient medication adherence, safety, and quality of care. In addition, using the DNP Essential II as an element of advanced leadership capability, stakeholders will show effective advanced communication skills/processes that guarantee patients access to quality care in line with their specific needs. Furthermore, the stakeholders must take responsibility for preparing CSP, reviewing and monitoring the clinical site’s policy, taking part in regular improvements of it, and ensuring that the participant understood all about the CSP.

Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice

American Association of Colleges of Nursing (2006) indicated that doctoral education is made effective through scholarship and research. Moreover, advanced practice registered nurses have a vital role in research and evidence-based practice. Essential III indicated analytic methods to critically appraise existing literature and other evidence to determine and implement the best evidence for practice. These were implemented entirely in this CSP through the immediate and in-depth process of searching and applying analytical methods to appraise existing literature, critically review articles that will support this CSP, and implement appropriate evidence-based strategies for practice. Furthermore, Essential III was used by integrating evidence, clinical judgment, interprofessional perspectives, and participants’ preferences in planning and implementing this CSP. Design and implementation processes to evaluate practice outcomes were also exemplified in this CSP. The goal of implementing this CSP is to improve participant hemoglobin A1C, which will improve society responses, conserve healthcare functionality, and improve participant quality of life.

Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care.

According to Kazandjian et al. (2021), Information technology promotes EBM practice by improving provider access to clinical evidence and supporting the appropriate application of clinical evidence to a patient and context. The development of information technology systems has led to the eagerness for digitization and electronic means of storing patient records to grease their handling through its development. Technologies such as smartphones, computers, and dozens of digital applications are used in different offices and homes. This CSP will utilize essential IV in sharing an everyday awareness and the importance of technology (smartphone (Medisafe) reminder apps) to help increase medication adherence at the same time, reduce hemoglobin A1C and also increase independence in self-care management. DNP graduates demonstrate knowledge of standards and principles for selecting and evaluating information systems and patient care technology and related ethical, regulatory, and legal issues (AACN,2006). These will also be utilized in this CSP because ethical consideration is implemented. It is non-invasive, and it will not cause any harm, and approval will be obtained from IRB communities before the implementation.


American Association of Colleges of Nursing (AACN) (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from

Kazandjian, V. A., & Lipitz-Snyderman, A. (2011). HIT or Miss: the application of health care information technology to managing uncertainty in clinical decision making…health care information technology. Journal of Evaluation in Clinical Practice, 17(6), 1108–1113.…


DNP Essential 1: Scientific Underpinnings for Practice

This essential demonstrates the philosophical and scientific underpinnings needed to complete a Doctor of Nursing. The Doctor of Nursing Practice (DNP) Essential 1 emphasizes providing patient care based on scientific knowledge and avoiding injuries. The Clinical Scholarly Project (CSP) requires an evidence-based project to be fulfilled before completing the DNP program. One of the requirements of completing the Institutional Review Board (IRB)form involves completing an extensive literature review on the chosen topic to see what was done in the past and how the project can add to the body of knowledge. This essential was fulfilled by choosing my CSP topic based on scientific knowledge and approved by the Clinical Scholarly Project Chair and sent for approval by IRB. The experience gathered from completing the DNP project will help to improve health outcomes and promote a science-based practice and the nursing profession.

Essential II – Organizational and Systems Leadership for Quality Improvement and Systems Thinking

The Doctor of Nursing Practice (DNP) Essentials II emphasizes organizational and systems leadership to quality improvement and systems thinking. The DNP- prepared nurse is equipped with the knowledge and skills to address the population’s needs. DNP-prepared nurses can make changes that will impact nursing science by translating nursing research into Practice (AACN, 2006). The goal of the DNP is to continuously ask questions make changes and quality improvements that will help improve patient outcomes through interdisciplinary collaboration. This essential will be fulfilled by assuming a leadership role in directing the CSP based on scientific knowledge. The main reason for conducting research is to generate new knowledge or validate existing practices. Evidence-Based Practice is consciously using current evidence in making decisions about patient care (Melnyk & Fineout-Overholt, 2011). It is a means of problem-solving that incorporates a system for critical appraisal and synthesis of the best and most relevant research to answer clinical questions.

Essential III – Clinical Scholarship and Analytical Methods for Evidence-Based Practice

The goal of the DNP III Essential is to improve patient outcomes with the skills acquired. It emphasizes using advanced clinical judgment, systems thinking and providing evidence-based care. The focus is on conducting comprehensive needs assessments assisting patients through complex situations. The role of the advanced practice nurse is geared towards providing quality care and improving patient outcomes. This essential will be met by reviewing current literature and using informatics to educate the study participants on weight loss, decreasing the risk factors of obesity, and guiding them through the project. DNP graduates bring a unique perspective in nursing by contributing to nursing science, evaluating, translating, and disseminating research into practice. This essential ultimately emphasizes the DNP graduate’s role in assimilating nursing science and practice with the complex needs of humankind (AACN, 2006).

Essential IV – Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

According to Moran et al. (2016), the attainment of a Doctor of Nursing Practice (DNP) is a degree and not a role. As defined in the American Association of College of Nursing (AACN, 2004), an advanced nursing role involves any nursing intervention that impacts the health outcomes of any individual or population. Such interventions may include direct care of patients, management of care for individuals and organizations, administration of nursing and health organization, and developing and implementing health policy (Moran et al., 2016). This essential will be met by using information technology in my research study to determine whether using the free mobile Sharecare app will help improve or reduce BMI in overweight and obese African American adults.


American Association of College of Nursing (2006). The essentials for doctorate education for advanced nursing practice. Washington D.C.

American Association of College of Nursing (2004). The essentials for doctorate education for advanced nursing practice. Washington D.C.

Katherine J. Moran, Dianne Conrad, & Rosanne Burson. (2016). The doctor of nursing practice scholarly project: Vol. 2nd ed. Jones & Bartlett.

Melynk, B.M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to the best way (3rd ed.). Wolters Kluwer.


Application of the Essentials of Doctoral Education for Advanced Nursing Practice I-IV

Essential I: Scientific Underpinnings for Practice.

DNP essential 1 emphasizes the importance of using science-based concept to evaluate and enhance health care delivery and improve patient outcomes. It explains that there are procedures and measures in nursing that must be followed to effect desirable shifts in health status using foundational knowledge from natural and social sciences (American Association of colleges of Nursing [AACN], 2006). In the same way, my CSP project aims to examine the effectiveness of a protocol-based group music intervention in the reduction of depressive symptoms and to improve wellbeing in older patients with dementia. The study will examine the impact of the SingFit mobile music app on patients with dementia. The use of music-based activities has been shown to impact the wellbeing of dementia patients with depression positively. Music as a tool can arouse memories, create a certain mood resulting in a change of behaviors in listeners, and enable communication in all age ranges and disease-afflicted individuals (Alzheimer’s Association, 2013). Comparably, as an APRN, I will employ this intervention and other significant interventions with foundational knowledge in the social sciences when working with patients in order to bring about a positive change in their health status.

II. Organizational and Systems Leadership for Quality Improvement and Systems Thinking.

DNP Essential II outlines a conceptual framework for advanced nurses to utilize system thinking and leadership skills to impact healthcare reform and quality improvement. DNP practitioners are able to approach complex situations with deep insight and innovation (Zaccagnini & White, 2011). This essential is vital because it integrates evidence-based nursing knowledge which has been acquired at the doctoral level with organizational systems (AACN, 2006). It discusses. It also discusses the double role the DNP graduate has to play in practice by understanding the clinical skills to care for patients as well as mastering the skills needed for organizational and policy advancement (AACN, 2006). role the DNP graduate has to play in practice by mastering the clinical skills to care for patients as well as mastering the skills needed for organizational and policy advancement (AACN, 2006). As a prepared DNP APRN, my future practice avail me the opportunity to utilize knowledge gained in the organizational and policy arena during my CSP activities. I will use my experiences to master quality improvement strategies in duplicating a successful, cost effective CSP that will be sustainable at an organizational level.

III. Clinical Scholarship and Analytical Methods for Evidence-Based Practice

Truly, nursing practice incorporates the science of caring with the scholarship to discover new understandings (AACN, 2006). This DNP Essential encompasses the avenue for discovering knowledge in nursing practice. The DNP prepared APRN is able to improve patient outcome through a systematic culmination of knowledge sought out from other disciplines and incorporated into evidence-based practice. This approach contrasts the research based doctoral programs in nursing which provide training on the discovery of new information using research (AACN, 2006). This DNP Essential clearly explains why my CSP activities are focused on an evidence-based intervention. My CSP does not seek to discover new knowledge, but to use approach known to work in the past, and to establish knowledge that will bring about a positive health outcome on alleviating depressive symptoms on adults suffering from dementia.

IV. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care

This DNP Essential is the foundation for the success of the DNP prepared APRN. The DNP graduate must demonstrate proficiency and leadership in the use of various platforms of information systems and technology to enhance patient care (AANC, 2006). During the course of my CSP activities and classes, I have learned to use a variety of technology to disseminate knowledge. Among other things, I have utilized Prezi, and Kaltura to disseminate information relating to my project. Providing information and sharing knowledge with my patients using Prezi and other platforms, as well as discussing various helpful mobile applications will be a service that I am convinced will result in positive health outcomes.


Alzheimer’s Association (2013). Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement;7(3):280-92.

American Association of Colleges of Nursing (AACN) (2006). The essentials of doctoral education for advanced nursing practice.…

Zaccagnini, M.E. & White, K.W. (2011). The doctor of nursing practice essentials: A new model for advanced practice nursing. Sudbury, MA: Jones & Bartlett.


The 8 Essentials can be described as a roadmap that may serve or is intended as a guide for APRNs and especially DNP graduate who intend to make a mark in the profession. Using the Essentials would help a fledgling APRN like me navigate my journey as I delve into the profession on a higher plane with bigger responsibilities associated with practicing at the APRN level. Apart from the Essentials serving as a useful tool in my CSP, I will use it as an underpinning for my career as an APRN in the nearest future.

ESSENTIAL 1: Scientific Underpinning for Practice.

I will apply Essential 1 which is scientific underpinning for practice as the foundation of my practice. It is important to remind myself regularly that the nursing profession is not only an art but a science (Jasmine, 2009). While still awaiting the IRB to approve my topic, I intend to use my CSP as scientific research to unearth new scientific innovations that will improve how some patients with anxiety are cared for. Because of the changing nature of our world especially changes in demography and population explosion, we may need to change the ways we care for patients especially psychiatric patients. Scientific research and innovations will facilitate the deliverance of high-quality care to our patients. This will have positive implications for healthcare costs and quality of care rendered (Dalen, 2009).

Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking

This essential emphasizes the importance of leadership, quality improvement and systems thinking in the nursing profession. Since a DNP-prepared APRN would operate in multiple positions, it is imperative that he or she has the necessary trainings and wherewithal to operate at the highest level of care provision. As a student working on my CSP, I intend to use the project to lead and direct the project, highlighting the importance of quality improvement at every point of the project. As a future APRN, I will endeavor to utilize the trainings and skill set I have acquired during my scholarship here at Umass Global to positively impact my work as a leader, and constantly work as a quality improvement advocate so that the patients I care for would benefit from high quality care.

Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice

This third Essential dwelt or is focused on scholarship/education, analytical methods, and importantly Evidence-based practice which is one of the hallmarks of the nursing profession. This Essential is important for my CSP because it highlights or reiterates the importance of using existing but relevant literature to unearth new evidence. As a practicing professional, scholarship in the form of continued education, serving as a preceptor and as a faculty, with the constant use of analytical methods would assist me to utilize numerous evidence from numerous nursing research work thus enhancing practice through use of evidence.

Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care.

The role played by information technology cannot be over emphasized in health care all over the world. The use of technology has not only helped the quality of care, but it has also helped to enhance the timeliness of care being provided, it has also improved collaboration amongst other healthcare providers. During my CSP, information systems/technology and patient care technology will play a major part as I attempt to identify whether the use of a music application on participants cellphones to download praise and worship songs will reduce anxiety symptoms in my CSP. Further, in the future, I will use technologies such as fax machines, telephones, software such as EPIC and others to access and transmit patients’ record electronically in providing care that is not only timely but safe for the patient.


American Association of Colleges of Nursing (2006). The Essentials of doctoral education for advanced nursing practice.…

Dalen, J.E. (2009). We can reduce US healthcare costs. The American Journal of Medicine. Vol. 123. No3. P.193-194.

Jasmine T. (2009). Art, science, or both? Keeping the care in nursing. Nursing Clinic of North America. 44(4):415-21. doi: 10.1016/j.cnur.2009.07.003. PMID: 19850178

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