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The Doctor of Nursing Practice (DNP) program is the highest practice degree in nursing. DNP-prepared nurses have the knowledge and skills to become leaders in the healthcare system. They play a central role in improving the quality of care and defining and evaluating change. DNP-prepared nurses must understand health economics to provide leadership, foster evidence-based practice and comprehend the underlying scientific practice. They need to know how financing influences nursing care, the underpinning economics of healthcare and the legal and regulatory policies that define the system.

Advanced practice registered nurses (APRN) can further their careers by enrolling in one of the MSN to DNP programs offered by reputable institutions such as Wilkes University. The DNP program is a terminal degree, and graduates are prepared with the highest nursing expertise to become leaders in advanced nursing practice. They improve patient outcomes and use research to inform practice. The curriculum builds on master’s programs by providing quality improvement, systems leadership, content in evidence-based practice and other key areas.

DNP nurses learn to deliver care at the practitioner level and understand policy and leadership. DNP programs teach nurses about social and behavioral science so they can evaluate evidence at the individual level and wider levels. The American Association of Colleges of Nursing has produced a DNP fact sheet that outlines the DNP program, its purpose and developments and relevant statistics. There are many career opportunities for DNP nurses, including working as healthcare executives, faculty educators, nurse practitioners, nurse midwives, nurse anesthetists, clinical nurse specialists, lobbyists and clinical nursing researchers. 

Evidence-based practice

Evidence-based practice (EBP) involves delivering the most effective care and using resources as efficiently and cost-effectively as possible. Nurse leaders must adapt to the economic context of the nursing practice environment and the organizational culture. EBP is a method for making clinical treatment decisions. It is a process that involves gathering information from contemporary scientific evidence to develop care provision strategies. It combines scientific research, health professional expertise and the patient’s preference. When related to clinical practice, this combination results in nurses making informed care decisions. 

DNP nurses make a difference in patient safety and the quality of patient care. Their doctoral education has taught them to use critical thinking, research methods and advanced clinical competencies. They are skilled at translating research findings into clinical practice so that the best available evidence influences patient care. DNP nurses use EBP interventions to enhance safety, improve outcomes and support patient satisfaction. Their expertise also allows them to recognize gaps in patient care and use strategies to improve all-round quality. 

Nurse leaders forge relationships between the research community and healthcare settings and advocate using evidence-based interventions. This ensures research is used effectively to improve patient care and a culture of research and innovation in nursing practice is developed. EBP reduces costs through enhanced outcomes, quality and safety. Improvements such as fewer healthcare-associated infections and shorter hospital stays lead to lower healthcare costs. EBP can also result in lower medication costs and fewer emergency room visits. 

A particular skill set is required for delivering EBP. DNP graduates have learned the core competencies to build EBP strategies. They have the analytical skills to assess scientific evidence when related to personalized patient care. They have critical thinking skills, which allow them to assemble the components of EBP efficiently and effectively, and the problem-solving skills to move the process forward. 

Financial management

Nurse leaders must be able to develop and manage annual operating budgets, apply the main economic concepts to healthcare organizations and use business models to amend healthcare delivery. They must be able to ensure the accuracy of billing mechanisms, manage financial resources and interpret financial statements. They also negotiate contracts with service providers, physicians and others. Nurse leaders must balance cost-conscious, responsible and compassionate care with their organization’s financial vision and goals. Depending on their role, they may be responsible for developing and implementing their department’s budget. Nurse leaders collaborate with the organization’s finance department for monitoring, approval, adjustments, and budget considerations. Healthcare budgets usually include capital and operating costs. 

The operating budget incorporates salaries and related expenses such as overtime, recruiting and training new staff. It also includes patient care supplies. To estimate the operating budget, nurse leaders should review past budgets, analyze trends and consider present needs. For example, a hospital with high staff turnover rates will have higher new staffing costs. The analysis could include admission numbers, length of stay and daily nursing care hours for each patient. When the nurse leader has determined the budget, they continue monitoring costs against the estimated and actual revenue so they remain within the costs forecast. 

The capital budget in nursing finance includes durable goods and large purchases and can include technology investments, medical equipment and structural building changes. Nurse leaders work with finance management for capital budget requirements. When these purchases are very costly, they may be paid for over several years. The costly nature of these purchases can result in payments over several years’ worth of budgets and involve additional approval steps. Hospital revenue usually comes from patient healthcare, such as diagnostic tests, surgical procedures, outpatient visits and hospital admissions. Nurse leaders do not have total control over the revenue generated but are responsible for keeping to their unit’s allocation to ensure alignment with the organization’s financial objectives. Nurse leaders can identify financial problems such as medical errors, accidents, training gaps, dated technology and high staff turnover. They can suggest ideas to the health administration that will generate savings for the organization.

Population health management 

Population health management (PHM) is the process of improving the health outcomes of a specific group of people through improved patient engagement and care coordination supported by relevant care and financial models. Health concerns are identified, and resources are allocated to improve the health of a group of people. The group size can vary, but all group members will share a common problem or characteristic. DNP graduates have the clinical and academic skills to improve care within population groups. Strong analytical and technical skills are required to develop population health programs and collect and manage data from sources such as electronic health records. 

Nurse leaders can implement PHM solutions and reduce healthcare costs by using automated care delivery systems and reducing waste and rates of medical errors. Strong nursing leadership skills are needed to implement PHM, improve health and reduce costs. When people are healthier, they spend less on healthcare throughout their lifetime. PHM prioritizes chronic disease management and preventative healthcare and reduces costs for individuals and communities. Some funds set aside to cover essential healthcare for low-income populations can be used for preventative medicine, technology and community education. Nurse leaders must examine the situation and be creative thinkers to implement value-based preventative care. 

Risk management

In clinical settings, managing risk is a continuing operational responsibility. It involves numerous practices developed to ensure safe processes that adhere to government and financial regulations. Financial risks include capital expenditure, insurance costs, malpractice litigation costs and inadequate insurance payments. Nurse leaders can look at the organization’s overall risk profile and evaluate how improvements to patient safety can positively impact finances. 

Nurse leaders can create risk management plans that provide guidelines to minimize risks or manage them if they happen. They can also develop risk management plans for situations that affect finances, including malpractice claims, compliance variations, medical errors, insurance claims and reimbursement levels. Studies have found that effective risk management plans can reduce the cost of medical errors. A risk management plan provides a framework for saving costs and avoiding risks that can affect the bottom line. When the chance of risks happening is reduced, recovering from them will be less expensive. When nurse leaders identify potential risks, liabilities can be reduced, resulting in fewer penalties and fines. They can identify possible risks by developing, implementing and monitoring risk management plans. The most effective plans cover policies, technology, risks and prevention. 

Quality improvement

When healthcare systems focus on quality improvement, they can save patients’ lives and make financial savings. Nurse leaders are often essential to the success of an improvement effort. They ensure their staff have the resources they need to implement the intervention. Quality improvements can benefit patients and deliver productivity and financial benefits to the healthcare organization. If care is not up to standard, it can result in waste and unnecessary costs. Examples include long stays in the hospital and problems caused by the care provided, such as pressure ulcers or infections, which affect health and lead to additional costs. If care is improved, it can lead to a boost in productivity and reduced costs. 

Some of the potential areas to save costs include eliminating the following:

• Reworking, performing a task more than one time.
• Overproduction, such as tests that are unnecessary.
• Moving people or materials when it is not necessary. 
• Defects, such as mistakes with medication.
• Low morale among staff who are being prevented from offering quality care.
• Delays, such as waiting lists for diagnostic tests. 

Productivity gains through quality improvement often do not result in money being saved, but they do provide the capacity to meet other service demands. 

Resource allocation

Nurse leaders must formulate an efficient resource management strategy. Their goal will be to provide the best services to patients with the available resources. Equitable resource allocation ensures everyone has their needs addressed. This requires accurate estimates of resource costs to reach an overall cost. Organizations need fair and safe allocation policies and procedures. Nurse leaders should make allocation decisions by following clinical and scientific evidence.

Resource management is a way to know exactly what there is in the healthcare setting, including supplies, equipment, human resources and raw materials. This increases productivity and reduces costs. It is possible to have action plans aligned with the organization’s budget and avoid decreased revenue. For example, if a hospital nurse leader knows how many sheets there are, they will also know when more must be ordered. This is an efficient and cost-effective way to manage resources. 

Healthcare policy

Nurse leaders have various skills that allow them to take part in advancing healthcare policies and improving health outcomes for individuals and communities. Being an effective advocate for improved health policy requires an understanding of the US healthcare system. Nurse leaders are in a good position to influence policy that affects staffing and patient care. They can communicate with officials about healthcare legislation related to nursing practice and policy issues. They can be positive role models for their staff and encourage them to get involved. Nurse leaders respond to healthcare financing and regulation changes with professional responsibility. Value in health spending has long been a priority in healthcare. 

Nurse leaders can become involved in politics and communicate with officials about legislation related to healthcare. Public policies influence systems, healthcare providers and their patients. Nurse leaders can help to promote health equity by becoming involved in public policies and decision-making at all levels. Health financing policies can help to address concerns. For instance, payment and contracting arrangements can encourage care coordination and better-quality care. Nurse leaders advocate for patients and best nursing practices, including financial aspects of healthcare. They lobby Congress and other organizations and offer the information and tools to allow nurses to share their views and expertise with policymakers. 

Conclusion

DNP-prepared nurses have the highest practice degree in nursing and use their leadership skills and expertise in nursing practice as nurse leaders. They are expected to be knowledgeable about healthcare economics and need clinical expertise, business acumen and financial awareness. DNP-prepared nurses are healthcare leaders who understand how finances influence nursing care and the policies that define the system. They ensure care is cost-conscious and aligned with their organization’s financial objectives. Finance is part of many nursing endeavors, including EBP, policies, population health programs and quality improvement interventions. DNP-prepared nurses are highly skilled and have the economic awareness to benefit healthcare finances.