AANA Task Force on the Doctoral Preparation of Nurse Anesthetists

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AANA Task Force on the Doctoral Preparation of
Nurse Anesthetists

• Sandra Ouellette, CRNA, MEd, FAAN
• Denise Martin-Sheridan, CRNA, PhD

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Objectives

• Background review
• Activities of the AANA DTF
• Preliminary findings
• Concerns

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Practice Doctorate
Practice Doctorate in Nursing
Au.D. Clinical Doctorate in Audiology
Doctorate in Clinical Nutrition (DCN)
Doctorate in Clinical Psychology
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Doctorate of Nursing Practice DNP
AACN Position Statement Patient Safety
IOM (2003)calls for nursing practice education
that prepares individuals with interdisciplinary,
information systems, quality improvement and
patient safety skills and expertise.
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Doctorate of Nursing Practice DNP
AACN Position Statement Complexity of Care
Interprofessional health care work environment is
complex Society demands and needs graduate
education in nursing
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Origin of DNP Movement
Who are AACN Members?
AACN Board of Directors
Schools of Nursing
Deans
Chief Nursing Officer
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Projected Timeline

• Approval of Essentials by AACN Board of
  Directors - July 2006
• Approval by AACN membership - October 2006
• 2015 Implementation
• Considered by CCNE as accreditation standards -
  Time to be determined
• NLNAC

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AACN The Essentials of Doctoral Education
Core Competencies for Practice
Curriculum
DNP Essentials 1-8 Specialty Competencies
1 Scientific Underpinnings 2 Organizational
Systems Leadership 3 Clinical Scholarship 4
Information Systems/Technology 5 Health Care
Policy 6 Interprofessional Collaboration 7
Clinical Prevention Population Health 8
Advanced Nursing Practice Specialty Competencies
1000 hrs of clinical practice
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curriculum
accreditation
evidence

program closure
legal/legislative
faculty
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quality
salary
knowledge
informed
level playing field
trend
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2006 AANA BOD
AANA Summit on Doctoral Preparation of Nurse
Anesthetists Appointment of Doctoral Task
Force Coordinated attendance at AACN
hearings Letter to Jean Bartels, President,
AACN Interim position statement
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Task Force Members
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Doctoral Task Force

• Purpose
• Develop various options for the doctoral
• preparation of nurse anesthetists to be
• considered by the AANA Board of
• Directors.

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DNP Task Force Objectives

• Develop options to move nurse anesthesia
  education to the
• doctoral level.
• 2) Develop plans to implement each option.
• 3) Develop a comprehensive communication plan.
• 4) Provide AANA leadership with periodic reports.
• 5) Review and provide input regarding external
  projects as
• requested.

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2007 Assembly of School Faculty Orlando, Florida
Relax and Pamper Yourself at the Renaissance
Orlando Resort at SeaWorld

• DTF Activities
• 4 meetings
• Several conference calls
• Reviewed published material on the topic ?
  possible impact
• Developed the draft interim position statement
  for BOD
• Published updates in the Journal and Bulletin
• Responded to e-mails
• Developed and conducted surveys data analysis
• Developed competencies
• Developing recommendations
• Developing white papers and analysis papers to be
  published in
• book format
• 11. Final report to the BOD in April 2007
• 12. Final report to the membership in August 2007
• 13. Speakers available to state associations

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Interim Position Statement on the DNP as Entry
into Advanced Practice for Nurse
Anesthetists February 2006 The American
Association of Colleges of Nursing (AACN) has
proposed that all advanced practice nursing
graduates, including nurse anesthetists, be
prepared with Doctorate of Nursing Practice (DNP)
degrees by 2015. The AANA cannot, at this time,
support AACNs position on the clinical doctorate
as entry into advanced practice since our initial
review of the proposal raises a number of serious
concerns. The AANA encourages
professional development for nurse anesthetists
up to the doctoral level. However, evidence
currently does not support mandatory clinical
doctoral degrees for entry into nurse anesthesia
practice. The AANA will make a decision on this
matter following stakeholder input, data
collection and analysis, and a thorough
assessment of the potential impact of requiring
clinical doctoral education on the profession and
the public we serve. Approved February
22, 2006 AANA Board of Directors
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DNP programs will increase the supply of
faculty for practice and instruction. Will the
practice doctorate, such as the DNP, be accepted
for didactic and administrative faculty?
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Facultyshould have additional preparation in
the science of pedagogy to augment their
ability to transmit the science of the profession
they practice and teach. Those planning a
faculty career will need preparation in teaching
methods, curriculum design, and program
evaluation. 1. Will CRNA faculty need to have
preparation in instruction, evaluation
and curriculum development (that few
possess)? 2. Will CRNAs be discouraged from
seeking faculty positions because of
the additional requirements?
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Competencies, content and practice experience
needed for specific roles in specialty areas are
delineated by national specialty nursing
organizations. How will AACN define specialty
nursing organization?
COA has been removed from the revised language
Each doctoral student should be taught basic
physiology, pathophysiology, Followed by
additional physiology and pathophysiology
relevant to the specialty. Will requiring basic
courses be redundant and take time away from
relevant course work and experiences?
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Masters degrees will become generalist degrees
for clinical nurse leaders. Does this mean
masters programs for nurse anesthesia should be
phased out?
DNP program faculty should maintain an active
connection to practice. Will CRNA program
administrators, required to maintain a clinical
practice, find this unduly burdensome? Will this
requirement discourage capable CRNAs from seeking
positions as program administrators?
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AACN coordinate lobbying efforts among
organizations to increase support for nursing
doctoral education through HHS Title VIII
program. What impact will this have on Nurse
Anesthesia Traineeships and other federal funding
programs?
moving from masters education to the DNP for
all specialty nursing education will require
changes in language in some state and federal
statues and in accreditation and certification
criteria. What impact will this have on nurse
anesthesia education, accreditation,
certification and practice?
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State Government AffairsAANA NewsBulletin, June
2006 Georgia to Implement Graduate Degree
Requirement for CRNAs
An Illinois law enacted in 2003 imposes a
grandfathering deadline of December 31, 2006 for
CRNAs who do not possess graduate degrees.
Scope and Standards for Nurse Anesthesia Practice
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The Essentials, a national, consensus-based
document, delineates the eight essential
competencies that must be attained by all DNP
graduates. How was it determined the
Essentials came from consensus? How will the
competencies affect nurse anesthesia education
and practice?
Dialogue with CMS is ongoing. Changes in this
regulatory language to require graduate level
education for reimbursement is being
sought. How will this affect those CRNAs who do
not have a graduate degree? How will this affect
CRNA reimbursement in general?
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AACN should work with regulatory and certifying
bodies through the Alliance on APRN Credentialing
to address the transition to the DNP for APN
entry into practice. AACN should work with
ANA and CMS to revise language in federal
regulations authorizing Medicare and Medicaid
reimbursement of APNs to require graduate level
education, rather than the MSN only, as the
eligibility criteria How will the effort to
change regulatory language be monitored? What
are the unintended consequences of these
statements by AACN? How will it be ensured
that our education, accreditation, certification,
funding and payment systems remain viable?
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September 11, 2006Volume 7, Number 21  AANA
Federal Government Affairs'HOTLINE   House
Health Subcommittees Agree to Hold Hearings on
Medicare Reimbursement Cuts
Current News Updates AANA Insurance Services
Update By John Fetcho, CPCU, ARMDirector, AANA
Insurance Services
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• Graduation from a nationally accredited DNP
  education program and national
• certification together serve as safeguard for
  quality practice
• This statement minimizes nurse anesthesia
  education programs that already
• prepare the clinical expert.
• 2. This statement infers doctoral programs in
  nurse anesthesia that will not award
• the DNP will graduate CRNAs who are not capable
  of quality practice.
• 3. What agencies will be recognized as the
  national accreditation and certification
• bodies?

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There will be components of the DNP which will
demand doctorally prepared faculty Masters
prepared faculty teaching in APRN programs will
have the option to complete the DNP Will all
faculty be required to be doctorally prepared?
DNP programs will be eligible for accreditation
by CCNE. Programs awarding a research doctorate
will not be considered by CCNE. Specialty
accreditation will continue by their respective
agencies. AACN will continue to strive for
congruence among the standards for
accreditation. of nurse midwifery, nurse
anesthesia and DNP programs.
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Competencies for the Doctorally Prepared CRNA
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Surveys Program Directors
n77/100
Highest education level
Do you support the AACN DNP concept
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Surveys Program Directors
n77/100
Should AANA promote the development of doctoral
programs for entry into practice
Do you support the vision of doctoral
preparation for entry into practice in the future
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Primary Benefit of Requiring Doctoral Degrees
for Entry to CRNA Practice
Percent
Educators n77/100 Practicing n 90/300 Students
n106/300
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Do You Support the AACNs Concept of the DNP
Entry into Practice by 2015
Educators n77/100 Practicing n 90/300
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Would you support a vision of a CRNA entry to
practice at the practice doctorate at some time
in the future?
Educators n77/100 Practicing n 90/300 Students
n106/300
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1. Develop an AANA position statement on doctoral
preparation for nurse anesthetists. 2.
Maintain current oversight of nurse anesthesia
education and certification. Identify
activities necessary to fulfill
recommendation Identify resources needed for
implementation Identify the individual group
responsible for implementation Suggest a
timeline for implementation
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