9: REFLECTIVE RESPONSE 1 ■ 227instrumental in helping PhD researchers to develop interventions that will be relevant
and scalable in clinical settings and key in rapidly translating research- based programs
into practice once their efficacy has been established through research.
As a result of continued variability in the preparation of DNP graduates, health
care systems also are confused about the role that DNP graduates should assume
(Melnyk, 2013). Hospitals and health care systems who hire DNP graduates should
expect that they are the best translators of research evidence into practice to enhance
quality of care, improve population health outcomes and reduce health care costs.
In their chapter, Gonzalez and Esperat mention that DNPs should conduct transla-
tional research. However, translational research should not be confused with EBP.
Translational research is rigorous research that studies the barriers and facilitators
of EBP and how best to translate research findings into practice whereas EBP is a
seven step problem- solving approach to the delivery of health care that integrates
the findings from well- designed studies with a clinician’s expertise and a patient’s
preferences and values (Melnyk & Fineout- Overholt, 2015; Melnyk & Morrison-
Beedy, 2012). It is only when clinicians deliver evidence- based care in an EBP cul-
ture and environment that it will sustain. Therefore, the DNP prepared nurse must
not only be an expert in EBP, but they must have advanced knowledge and skills in
facilitating individual behavior and organizational system change as many practic-
ing clinicians do not consistently deliver evidence- based care and they must learn
these new skills.
The DNP prepared nurse also must meet the new research- based EBP competences
for practice nurses and advanced practice nurses. These advanced practice competen-
cies include:
- Systematically conduct an exhaustive search for external evidence to answer
clinical questions - Critically appraise relevant pre- appraised evidence and primary studies,
including evaluation and synthesis - Integrate a body of external evidence from nursing and related fields with
internal evidence in making decisions about patient care - Lead transdisciplinary teams in applying synthesized evidence to initiate
clinical decisions and practice changes to improve the health of individuals,
groups and populations - Generate internal evidence through outcomes management and EBP imple-
mentation projects for the purpose of integrating best practices - Measure processes and outcomes of evidence- based clinical decisions
- Formulate evidence- based policies and procedures
- Participate in the generation of external evidence with other health care
professionals - Mentor others in evidence- based decision making and the EBP process
- Implement strategies to sustain an EBP culture
- Communicate best evidence to individuals, groups, colleagues, and policy
makers (Melnyk, Gallagher- Ford, Long, & Fineout- Overholt, 2014). Mentor-
ing registered nurses and advanced practice nurses to meet the new research-
based EBP competencies also should be inherent in the DNP role.
Both PhD prepared researchers and DNP prepared clinical scholars fulfill key roles
in our health care system, but it is imperative that academic programs prepare each for
the role they were intended to assume in our health care systems. Together, new evi-
dence will be generated and quickly translated into practice and policy to improve the
quality of health care and population health outcomes.