10: REFLECTIVE RESPONSE ■ 253advancing and achieving optimal outcomes for individual patient, family, community,
population health, and in their various organizational settings (McCauley, 2014). Using
the direction, alignment, and commitment (DAC) framework (McCauley, 2014), I suc-
cinctly share how I believe that DNP- prepared nurses are using their competencies to
mitigate CUVA, and make positive change happen in health care.
Set Direction: Leveraging knowledge and skills gained from DNP foundational
competencies outlined in the AACN DNP essentials, specifically Essentials I, II,
and III, DNP nurses are able to effectively set direction by operationalization, a
vision and strategy to address identified organizational gaps related to their ex-
pertise. This strategy will involve providing leadership that customizes organi-
zational goals to meet patient and population health goals. DNPs have acquired
the skills to thread efficiency and productivity in their work. DNPs understand the
imperative to leverage the political capital of those who already shared in
the direction/ vision to influence others for success.
Create Alignment: DNPs know that creating and achieving alignment starts with
a good understanding of what needs to be accomplished in order to create a
powerful voice for change. It encompasses bringing together the right config-
uration of passion and talent, to use the structure and process that is in place
to enable change. DNP Essentials IV, V, and VI emphasized technology, health
care advocacy and interprofessional collaboration. These competencies out-
lined in the DNP essentials accentuate elements that are vital to creating align-
ment. The DNP- prepared nurse can accelerate alignment by involving many
stakeholders throughout the organization or unit in crafting an implementa-
tion plan for the direction that was set. An important aspect of alignment is
congruence between the organizational goals and vision that are used to set
the direction. In essence, DNPs know, among many other things that the or-
ganizational leadership strategy must align with the outcome sought by the
DNP- prepared nurse.
Gain Commitment: DNPs appreciate the value of getting the buy- in of organi-
zational leadership and the whole organization to the direction that has been
set. Competencies of DNP Essentials VI, VII, and VII, such as effective com-
munication, advanced system thinking, and ability to leverage conceptual and
analytical skills are crucial for gaining commitment. DNP- prepared nurses gain
commitment for their cause by connecting the directions they have set to the
existing motivation of individuals in the organization. This strategy results in
a contagious effect, as palpable commitment of early adopters often snowball
through the entire organization or unit, intensifying and growing, including the
DNP’s own commitment.■ CONCLUSION
In the fast- paced, evolving health care environment, the nursing profession has risen to
the challenge by preparing nurses with terminal degrees, who hold the tools to make
positive contributions in solving some of the challenges of the nation’s health and health
care delivery system. Knowledge and education are powerful instruments for change.
DNP- prepared nurses possess practice experience, leadership competencies that include
change management and knowledge of research and evidence- based practice, skills that
are essential to mitigate CUVA and meet the needs of changing health care consumers in
an evolving health care environment.