2009/2010 - 18
PROPOSED MANDATE FOR UNIVERSITY COUNCIL
TITLE: Proposal to establish a Doctor of Nurse Anesthesia Practice degree in the
College of Arts and Sciences
OBJECTIVE:
To establish a practice doctorate in the discipline of Nurse Anesthesia in order to build on
our successful masters degree program and to comply with upcoming requirements that
the practice doctorate will become the minimum qualification to enter the field of nurse
anesthesia.
REASONS FOR PROPOSED MANDATE:
Saint Joseph’s University has a long-standing and successful partnership with Nazareth
Hospital to offer a M.S. in Nurse Anesthesia. Recently the accrediting body for nurse
anesthesia programs (the American Association of Nurse Anesthetists) has mandated that
schools must begin a process of transition to offering practice doctorates as the minimum
qualification for nurse anesthetists by 2020. The Department of Health Services at SJU
and our partners at Nazareth would like for SJU to be at the forefront of this transition as
a way to continue the tradition of academic rigor and excellence in this degree program
and to position the program strategically in the marketplace.
RECOMMENDED FOR STUDY BY WHICH BODY?
_____ Faculty Senate:
Academic Policies and Procedures Committee
_____ Faculty Senate:
Faculty Policies and Procedures Committee
___X_ College Council:
College of Arts and Sciences
_____ College Council:
Haub School of Business
_____ Standing Committee on Student Affairs, Full-time Undergraduate
_____ Standing Committee on Student Affairs, Part-time Undergraduate/Graduate
_____ Administrative/Staff Council
Signature: Dr. Sabrina DeTurk, Associate Dean, Graduate CAS_ Date: 4/30/10
Please forward to the Provost who serves as Chair of the University Council, along with
complete documentation to substantiate the need for the proposed mandate.
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Proposal for Doctorate of Nurse Anesthesia Practice Degree (DNaP)
Saint Joseph’s University in Partnership with Nazareth Hospital
Overview
The purpose of this proposal is to establish a post-masters practice doctorate
degree in nurse anesthesia at Saint Joseph’s University and Nazareth Hospital School of
Nurse Anesthesia. The program will be offered in an online format and tailored
specifically for practicing nurse anesthetists. The curriculum is designed for successful
completion as a one-year cohort offering, which utilizes an integral Capstone experience
as the central scholarly component. The option for part-time matriculation could also be
made available on a limited basis.
The curriculum content for the practice doctorate in nurse anesthesia has already
been well defined by the nurse anesthesia accrediting organization, the American
Association of Nurse Anesthetists (AANA) Council on Accreditation. The curriculum is
conceptually organized into three major components: professional leadership, education
in nurse anesthesia, and practice scholarship.
The program will be thirty credits, with
eight individual three-credit courses and one six-credit Capstone course.
I. Professional Leadership: Nurse Anesthesia Professional Practice, Quality
Improvement in Patient Safety, & Ethics and Legal Issues in Healthcare.
II. Education/Administration in Nurse Anesthesia: Leadership in Nurse Anesthesia
Education Administration, Curriculum Development and Teaching Strategies,
& Advanced Simulation in Nurse Anesthesia Education.
III. . Practice Scholarship: Evidence-Based Practice in Nurse Anesthesia,
Grantsmanship and Authorship , & an Integrative Capstone Project.
Rationale
Nazareth Hospital School of Nurse Anesthesiology and Saint Joseph’s University
have enjoyed a successful collaborative educational partnership for over twenty years.
There is high regard at Nazareth for the Master’s degree preparation that our anesthesia
students receive from the Health Education and Health Administration graduate program.
In 2005, Nazareth and Saint Joseph’s University achieved the esteemed ten-year re-
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accreditation award from the AANA Council on Accreditation. As the maximum term
granted, this ten-year re-accreditation is an external validation of our mutual capacity to
graduate extraordinary nurse anesthetists.
Over the past several years the AANA has been studying the significant
transformational change that has occurred in the educational preparation of all allied
healthcare practitioners; particularly as they transition from master’s to practice-focused
doctoral degree preparation for entry into professional practice. These professions have
included: pharmacy, optometry, audiology, physical therapy, and occupational therapy.
Doctoral programs in these professions fall into two principal types: research focused and
practice focused.
Practice-focused doctorates are designed to prepare expert scholar-
practitioners, who are skilled at applying credible research findings for the innovative and
evidence-based advancement of the profession. Rather than the origination of new
knowledge through a research and dissertation process, practice doctoral students carry
out a scholarly Capstone Project that applies knowledge to solve a problem through
translation of research into practice with the dissemination and integration of new
knowledge. This year long project is a quality improvement initiative implemented in
the educational, administrative, or clinical arena that culminates in the preparation of a
manuscript suitable for submission to a professional journal.
In 2008, the AANA officially decided to mandate the practice doctorate as the
terminal degree for entry into nurse anesthesia practice. To allow adequate time for
programs to transition to the practice doctorate, the AANA has set forth the following
deadlines:

new nurse anesthesia programs applying for accreditation after 2015 must be
formatted as a doctoral curriculum

program directors and associate directors must possess a doctorate by 2018

all nurse anesthesia programs must be organized as practice doctorate degree
granting programs by 2020.
While 2020 may initially appear distant and non-urgent, there are other factors that
require consideration. The primary factor is our 2010 mid-accreditation cycle self-study
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and the ongoing preparation for our reaccreditation process beginning in 2014.
These
two variables necessitate that Nazareth Hospital School of Nurse Anesthesia has a
formalized plan for their successful future transition to a practice doctorate program.
Nazareth has been working closely with the administrative faculty at Saint Joseph’s
University, including John Newhouse, Sabrina DeTurk, and Bill Madges, over the past
two years to devise an effective and successful transitional curriculum that will culminate
in the achievement of the AANA 2020 practice doctorate mandate.
This proposal for
the implementation of an online post-masters doctorate of nurse anesthesia practice
(DNaP) is the opportunity that will solidify the significant ongoing collaboration between
our two schools.
The majority of post-masters Doctorate of Nursing Practice degrees (including
those that are anesthesia specific) are offered exclusively online or in a hybrid format.
The implementation of the online post-masters DNaP program at Saint Joseph’s has
several important factors that will contribute to programmatic success and ease of
implementation. As a nurse anesthesia program that is offered through both a University
and hospital that share a Catholic heritage and reputation for excellence, there has been a
tremendous response from our alumni and their colleagues expressing desire to pursue
their post-masters doctoral preparation at Saint Joseph’s. Contributing to its fine
reputation is a well-established and respected Health Administration and Health
Education graduate program, a new graduate Health Care Ethics program, as well as, a
Doctoral program in Education.
The graduate program in Health Administration
launched an online degree program in Spring 2010 that has attracted a significant number
of students, indicating that demand for online programs among health care professionals
is high. The online Doctoral program in Nurse Anesthesia would have the option of
providing a residency component for its students, similar to that planned for the online
Organizational Development and Leadership program.
Nurse anesthetists are highly specialized providers of care and, as such, are
fundamentally attracted to a doctoral curriculum that has been designed for their
advanced practice role in anesthesia.
St. Joseph’s University will be the only regional
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practice doctorate program specializing in nurse anesthesia in a region that has the most
concentrated amount of nurse anesthesia graduates across the country.
In addition, our
collective full-time nurse anesthesia cohort starting September 2009 is the largest to date
with twenty-five students. These students represent a large proportion of prospective
applicants who will desire to continue their matriculation into the new DNaP program, as
all graduates will likely seek doctoral preparation in order to have educational parity with
future colleagues.
The SJU Plan 2010: The Path to Preeminence calls for an official recognition of
curricula at Saint Joseph’s University that fulfill the criteria for consideration as a
signature program.
Nazareth Hospital School of Nurse Anesthesia fulfills many of
those signature program characteristics detailed by the University as requisite
benchmarks for excellence.
Also, the implementation of the DNaP program at Saint
Joseph’s University will ensure the continued preeminence of Nazareth and Saint
Joseph’s as the prominent educator of highly regarded nurse anesthetists known to be
cultivated in the academic excellence of the Jesuit tradition.
Accreditation and Timeline for Implementation
According to Kathleen Gaval, regional accreditation for a new post-masters
practice Doctorate will likely be required from the Pennsylvania Department of
Education and Middle States. Upon Saint Joseph’s University approval for the
institution of the DNaP program, the AANA Council on Accreditation self-study process
can be initiated and will be done by Nazareth Hospital School of Nurse Anesthesia
faculty.
Timeline for implementation of the DNaP program is, therefore, entirely
dependent upon the successful completion of these processes.
With consideration of the
recent past experience of colleagues engaging in these approval and accreditation
processes, a realistic and anticipatable start date would be Summer or Fall 2011.
The existing Master’s degree program in Nurse Anesthesia will continue to run
for at least 2 – 3 years after the launch of the DNaP program. We anticipate that there
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will still be a demand for Master’s degrees in this field for some time. However, as 2020
approaches, SJU and Nazareth will look at how to combine the Master’s and Doctoral
programs into one degree program that satisfies the requirement that all nurse anesthetists
be doctorally prepared.
Projected Enrollment and Tuition
An initial 15 students is a reasonable first-year cohort.
This amount is
appropriate to achieve a meaningful collaborative online academic community and is
manageable for current Nazareth nurse anesthesia faculty to serve as academic advisors
for the integrative Capstone Project.
There is tremendous potential growth opportunity,
as each successive year there will be over 150 nurse anesthesia graduates in Philadelphia
of whom the desire to achieve doctoral preparation will continue to mount as the 2020
AANA deadline approaches, at which time, the DNaP will become the required degree
offered by Saint Joseph’s for all Nazareth nurse anesthesia students.
Additionally, as
an online program, the DNaP will be recruiting students nationally.
Resources (see enrollment projections and budget below)
The program would require an upfront investment of $222,000 in the first year to
cover costs of course development and faculty. However, if enrollment projections are
accurate, the program would still generate positive net revenue in that first year of
$156,900. An open question is whether to develop and market the program through our
partnership with Deltak (the organization which currently markets and recruits for our
online degree programs in Graduate Arts and Sciences) or to keep both the development
and marketing/recruiting of the program in house. If the program is run with Deltak (the
model used in the budget assumptions provided here) they would cover marketing and
recruiting expenses, but also take a share of the generated revenue. Given the very niche
market for this program, it might be viable for SJU to run the online DNaP without
Deltak’s assistance (utilizing the current marketing budget and recruitment structure in
Graduate Arts and Sciences) and thus retaining all net tuition revenue. The pros and cons
of each option will be carefully vetted should the program receive approval.
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Curriculum
The DNaP program is designed for students who already possess a Master of
Science in Nurse Anesthesia degree, obtained either at Saint Joseph’s University or
another accredited institution. Students will enter and progress through the program in
cohorts of no more than 20 students.
Semester 1:
GRA 7xx Nurse Anesthesia Professional Practice (3 credits)
Emphasizes learning through advanced clinical experiences in anesthesia practice.
Explores concepts of nurse anesthesia practice, competence, and expertise, the use of
critical thinking skills, and reflection as an evaluation method. This course prepares
students with skills and competencies needed to build and assimilate knowledge for
establishing a scholarly trajectory at a high level of complexity. This is the foundation
course for the culminating Capstone project focusing on improving nurse anesthesia
practice or education.
GRA 7xx Quality Improvement in Patient Safety (3 credits)
This course focuses on the role of the nurse anesthesia leader in quality
improvement initiatives. Introduces a systems approach to error investigation and
analysis. Focuses on the analysis of adverse patient events from a systems perspective
and the use of multidisciplinary teams to solve patient management problems. The
emerging scientific knowledge base for assuring and improving patient safety outcomes
is examined. Adherence with governmental regulations requiring the ongoing collection,
assessment, and reporting of key metrics and the achievement of safety benchmarks is
discussed.
GRA 7xx Ethics and Legal Issues in Healthcare (3 credits)
This course provides a foundation for values, codes, and legal principles
governing decisions in advanced nurse anesthesia practice, conduct, and relationships.
Legal aspects addressed include: medical malpractice, informed consent, patients' rights,
billing fraud and abuse, and governmental regulation of health professions and healthcare
facilities. Using the AANA Code of Ethics as a frame of reference, real-life case
scenarios of difficult or controversial decision-making are examined.
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Semester 2:
GRA 7xx Evidence-Based Practice in Nurse Anesthesia (3 credits)
This leadership course provides a foundation for life-long scholarship, utilizing
evidence-based practice. Specific skills for evaluating, interpreting, and integrating
scientific research into nurse anesthesia practice and education are developed. The
course consists of a clinical component where students engage in an evidence-based
practice project with their assigned mentor applying concepts of evidence-based practice.
GRA 7xx Grantsmanship and Authorship (3 credits)
This course introduces students to strategies, skills, and technical competencies
for grant seeking and writing. Authorship strategies, skills, and technical competencies
are developed. Doctoral students are expected to submit a manuscript detailing their
respective Capstone project, that is suitable for publishing, prior to graduation.
GRA 7xx Advanced Simulation in Nurse Anesthesia Education (3 credits)
State of the art simulation training instruction is provided in an operating room
setting with a high fidelity simulator. Current strategies are reviewed for enabling
students to acquire the technical, leadership and teamwork skills required to effectively
respond to the challenges of high acuity - low occurrence anesthesia scenarios, such as
malignant hyperthermia, shock, MI, anaphylaxis, and difficult airway/ intubation.
Semester 3 and 4:
GRA 7xx Curriculum Development and Teaching Strategies (3 credits)
Examines principles of teaching and learning applicable to the anesthesia didactic
and clinical environment. Presents strategies in teacher/learner communication,
presentation development and strategies, curriculum design, and methods of evaluation
pertinent to nurse anesthesia education.
GRA 7xx Leadership in Nurse Anesthesia Education (3 credits)
Provides analytical, critical, and innovative thinking regarding topics pertinent to
support and improve the performance of nurse anesthesia education.
GRA 7xx Integrative Capstone Project (summer I & II ~ 6 credits total)
This course provides for the further continuation of the evidence-based practice
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Capstone project with their assigned mentor.
Students engage in the selection and
implementation of appropriate Capstone evaluation methods. Data regarding the
Capstone efficacy of enacting an evidence-based quality improvement initiative is
evaluated.
Meaning is derived not only from the evaluative data, rather also from the
Capstone experience in totality. The student's plan of action for continuing on a
scholarly trajectory are delineated and emphasized.
Projected Budget - DNaP Program
assumes first cohort of 15 starting each summer from 2011 forward
Gross Revenue Projections
Courses Offered
Total Registrations/year (15 students x 9 courses)
Credit Hours/year (registrations x 3 credits
Per credit tuition*
Revenue($800/Cr)
* current Ed.D. tuition level w/3% incr./year
FY 2012
FY 2013
FY 2014
FY 2015
10
10
10
10
150
150
150
150
450
450
450
450
842
867
893
920
$378,900 $390,150 $401,850 $414,000
Expense Projections
Course Development Costs ($18K/Course)
Adjunct Faculty Cost ($6K/Course)
Expenses Total
FY 2012
FY 2013
FY 2014
FY 2015
$162,000
$0
$0
$0
$60,000 $60,000 $60,000 $60,000
$222,000 $60,000 $60,000 $60,000
Net Revenue Projections
Total Generated Revenue
SJU Revenue (assuming 50% split w/Deltak)
FY 2012
FY 2013
FY 2014
FY 2015
$156,900 $330,150 $341,850 $354,000
$78,450 $165,075 $170,925 $177,000
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Proposed Schedule of Courses - DNaP - first 9 semesters of offerings
Semester
Summer 2011
Course
GRA 701
GRA 702
GRA 703
Cohort
DNaP 1
DNaP 1
DNaP 1
Fall 2011
GRA 704
DNaP 1
GRA 705
GRA 706
DNaP 1
DNaP 1
GRA 707
DNaP 1
GRA 708
GRA 709
cohort 1
DNaP 1 completes
DNaP 1 May 2012
GRA 710
GRA 710
DNaP 1
NOTE: the capstone is a 6 credit course shown here as 2 courses to
facilitate budget projections
Summer 2012
GRA 701
GRA 702
GRA 703
DNaP 2
DNaP 2
DNaP 2
Fall 2012
GRA 704
GRA 705
GRA 706
DNaP 2
DNaP 2
DNaP 2
Spring 2013
GRA 707
GRA 708
GRA 709
GRA 710
DNaP 2 cohort 2
DNaP 2 completes
DNaP 2 May 2013
DNaP 2
Summer 2013
GRA 701
GRA 702
GRA 703
DNaP 3
DNaP 3
DNaP 3
Spring 2012
LEGEND
Temporary Course #
GRA 701
GRA 702
GRA 703
GRA 704
GRA 705
GRA 706
GRA 707
GRA 708
GRA 709
Course Name
Nurse Anesthesia Professional Practice
Quality Improvement in Patient Safety
Ethics and Law in Healthcare
Evidence-Based Practice in Nurse Anesthesia
Grantsmanship & Authorship
Advanced Simulation in Nurse Anesthesia
Education
Curriculum Development and Teaching Strategies
Leadership in Nurse Anesthesia Education
Integrative Capstone Project I
Integrative Capstone Project
II
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