The Impact of Doctor of Nursing Practice Education on Career Advancement and Professional Satisfaction: A Scoping Review

ABSTRACT

Aim

To explore the impact of Doctor of Nursing Practice (DNP) education on career advancement, job satisfaction, leadership competencies and contributions to healthcare systems.

Design

The study utilised a scoping review methodology based on Arksey and O'Malley's (2005) framework.

Methods

The search strategy was developed with an academic librarian to ensure thoroughness and relevance. Seven databases were searched using MesH terms. Inclusion criteria focused on peer-reviewed studies examining DNP education's influence on career advancement, job satisfaction and leadership. Thematic analysis was used to identify patterns and themes.

Data Sources

Studies were selected based on their focus on DNP-prepared nurses, nursing faculty or advanced practice nursing students in healthcare or academic settings, published between 2004 and 2024.

Results

Twenty-one studies met the inclusion criteria, highlighting DNP education's role in fostering leadership, professional development and evidence-based practice. Thematic analysis revealed the benefits of being a DNP graduate include contribution to professional development, contribution to leadership and contribution to the practice environment. The challenges to DNP graduates include underrecognition of competencies, high educational costs and limited academic opportunities that were also identified.

Conclusions

DNP education contributes to individual and professional growth, leadership development and healthcare system improvements. However, barriers such as financial constraints and inadequate recognition of DNP competencies must be addressed to maximise the impact of this educational model.

Implications for the Profession and/or Patient Care

DNP education empowers nurses to lead healthcare innovations, enhance patient care quality and reduce disparities in health outcomes. Strengthening financial and systemic support for DNP graduates is essential for sustaining these contributions.

Impact

DNP education is a transformative force in nursing, offering significant opportunities for leadership development and healthcare advancements. Aligning DNP programmes with evolving global healthcare challenges can further strengthen their impact on the profession and patient care.

Reporting Methods

PRISMA-ScR guidelines were followed.

<i>“What’s the point, when we’re already dead?”</i> Implementation challenges of COVID-19 public policies for indigenous peoples in the Peruvian Amazon: A sequential multi-method qualitative study

by Andrea Valdivia-Gago, Patricia J. García, Sherilee L. Harper, Angela Soria, Carol Zavaleta-Cortijo

Peru issued multiple COVID-19 policies for the Amazon, yet how they worked in practice for Indigenous Peoples remains under-documented. We conducted a sequential multi-method qualitative study, reviewing 20 national and regional policy documents (Mar–Dec 2020) and interviewing 12 implementers, regional and local officials from the health sector (n = 8) and the Ministry of Culture (n = 4), plus one central-level culture representative, in Loreto and Junin. Triangulating top-down policy review with bottom-up practitioner accounts across two contrasting regions strengthened validity. Policies frequently lacked explicit intercultural guidance, clear monitoring indicators, and dedicated budgets. Implementers described budget misalignment, omission of specific health networks, delayed supplies, and connectivity barriers that fostered dissatisfaction and a perception that services prioritized data collection over care. Effects were most acute in remote and low-connectivity settings; Indigenous federations’ participation in Loreto sometimes mitigated challenges, while in Junin travel-fund constraints limited participation. Pandemic preparedness must institutionalize intercultural approaches and secure sustainable funding with clear accountability. Co-design with Indigenous organizations, ring-fenced implementation budgets, practical communication strategies, and routine monitoring are essential to protect Indigenous Peoples in future health emergencies.

Prevalence and associated factors of suicidal behaviours and non-suicidal self-injury among youths of Gurage Zone, Ethiopia 2024: a community-based cross-sectional study

Objective

To assess the magnitude and associated factors of suicidal behaviour and non-suicidal self-injury (NSSI) among youth of the Gurage Zone, Southern Nations, Nationalities, and Peoples Regional, Ethiopia, 2024.

Study design

A community-based cross-sectional study was conducted.

Setting

This research was carried out in the Gurage Zone.

Study participants

This study was conducted among 719 Gurage Zone youths from 1 January 2024 to 1 February 2024.

Outcome measures

Suicidal behaviours and non-suicidal self-injury were assessed using a pretested, interviewer-administered, structured questionnaire. Data were entered in EpiData V,3.1 and exported to SPSS V.25 for analysis. A binary logistic regression model was used to identify significant factors associated with suicidal behaviours and NSSI. Variables with a p-value less than 0.05 and adjusted ORs with 95% CI were used to declare association with the outcome variable in the final model.

Results

Out of the total 820 study participants, 719 participants participated in the study, giving a response rate of 88%. Among 719 respondents 465 (64.7%) were males. The prevalence of high risk of suicidal behaviours was 11.7% (95% CI 8.14 to 14.30) and it is significantly associated with substance use in the last 3 months (adjusted OR (AOR)=6.84; 95% CI 3.48 to 13.47), having moderate insomnia (AOR=3.09; 95% CI 1.30 to 7.31) and having depression (AOR=6.84; 95% CI 3.48 to 13.47).

The prevalence of NSSI among youths was 38% (95% CI 34.52 to 41.86). Substance use in the last 3 months (AOR=2.459; 95% CI 1.59 to 3.81), youths having depression (AOR=3.348; 95% CI 2.29 to 4.91), youths who were exposed to stressful life events (AOR=9.86; 95% CI 6.46 to 15.07) were significantly associated with NSSI.

Conclusion

Nearly 1 in 10 youths in the Gurage Zone exhibited high-risk suicidal behaviour, and over one-third reported NSSI. Suicidal behaviour was significantly associated with substance use, depression and moderate insomnia, while NSSI was significantly associated with substance use, depression and exposure to stressful life events. These findings highlight the prevalence of self-harm and the key factors associated with these behaviours among youth in this region.

Investigating barriers to adherence to antimalarial prescribing guidelines in public healthcare facilities in Arba Minch, South Ethiopia: A qualitative study

by Abate Atimut Dereje, Dereje Geleta, Tadesse Menjetta, Abinet Takele, Susana Vaz Nery, Techalew Shimelis

Background

Early diagnosis and prompt treatment of malaria cases are a crucial component of curative and preventive interventions. There have been reports of healthcare workers overprescribing antimalarial agents against guidelines, but the barriers they face in adhering to the guidelines are not well studied. This study aimed to investigate barriers to adherence to guidelines in prescribing antimalarial drugs in public healthcare facilities in Arba Minch, South Ethiopia.

Method

A cross-sectional descriptive exploratory qualitative method was employed. We included ten participants from public healthcare facilities, including health centres, a hospital, a city health office, and a zonal health bureau. A key informant interview technique was used to collect data. All interviews were audio-recorded, transcribed, and analyzed. Data analysis was performed using ATLAS.ti, version 7.5 software. The results were presented thematically and narrated to support the main themes.

Results

Public healthcare facilities primarily used blood smear microscopy to test all malaria-suspected patients. However, in cases of microscopy service interruptions or when confirming negative results, rapid diagnostic tests (RDTs) were employed in some facilities. Limited availability of microscopes and reagents, and electric power interruptions hindered reliable microscopy services. Drug stock-outs, patient expectations for antimalarial drugs, self-treatment, and delayed care-seeking are barriers to adherence to malaria treatment guidelines. The main reason for non-adherence to withholding antimalarial drugs after negative tests was greater trust in clinical findings over laboratory results. Confidence in experience contributed to trust in clinical judgment, while perceived inexperience and negligence, inconsistent RDT and microscopy results, and poor-quality control assessment results undermined trust in laboratories. Despite supporting the guidelines, study participants emphasized the need for flexibility to allow empirical treatment and highlighted the lack of training and mentoring for healthcare workers.

Conclusion

To improve adherence to malaria treatment guidelines, it is essential to ensure consistent lab operations, enhance quality assurance, maintain effective communication between lab personnel and prescribers, and provide healthcare and patient education. Implementing training and mentoring programs and promoting evidence-based practices are also crucial.

Family caregiver burden and associated factors among caregivers of people with mental illness attending outpatient treatment in public hospital in Eastern Ethiopia, Ethiopia: hospital-based cross-sectional study

Objective

To assess family caregiver burden and associated factors among caregivers of people with mental illness in Eastern Ethiopia.

Design

Cross-sectional study.

Setting

Three hospitals in Eastern Ethiopia.

Participants

A total of 422 family caregivers of people with mental illness were recruited using systematic random sampling, of whom 417 participated (response rate 98.8%).

Primary outcome measures

Caregiver burden was assessed using the Zarit Burden Interview (ZBI-22). Linear regression was used to measure the associations between dependent and independent variables.

Results

The mean score of the ZBI was 47.971 (SD=14.539). In our study, factors associated with caregiver burden included age of caregivers (β=0.143, p=0.006), sex of the caregiver (β=0.121, p=0.007), time spent in providing care (β=0.194, p=0.006), presence of comorbid medical illness (β=0.309, p0.001), substance use in the last 12 months (β=0.265, p=0.024), perceived stigma (β=0.207, p

Conclusions

89 (22.2%) of caregivers reported severe burden and 220 (52.8%) reported moderate-to-severe burden. Family caregivers play a critical role in the treatment of mental illness; there is a need to establish family caregiver support services, such as group therapy and psychoeducation.

Antibody development after three mRNA SARS-CoV-2 vaccinations in patients with systemic autoimmune rheumatic disease with and without treatment: an observational cohort study

Objectives and design

To further elucidate the effects of rare systemic autoimmune rheumatic diseases (SARD) and their treatment on antibody development after vaccination against SARS-CoV-2, we compared patients with and without immunosuppressive therapy to healthy controls in an observational cohort study.

Participants and setting

We enrolled 52 patients with SARD and 72 healthy subjects in a prospective, observational study at the Medical University of Vienna and measured the humoral response 6 months after two mRNA vaccinations and 2–6 weeks after a third dose.

Results

Patients with vasculitis showed significantly (p=0.02) lower antibody titres 6 months after vaccination (median 247 BAU/mL, IQR [185–437]), as compared with healthy controls (median 514 BAU/mL, [185–437], IQR 323; 928, vasculitis patients: 247, IQR [185; 437], p

Conclusions

Patients with SARD displayed lower antibody development after booster vaccination, even if antibody levels after two immunisations were comparable to healthy controls. Our data may be limited due to sample size, but it provides pointers for a more individualised, antibody-titre-oriented approach and earlier booster vaccination in patients with SARD.

¿Es la técnica de la moxibustión eficaz para corregir la malposición fetal?

El auge de las terapias complementarias y las diversas y contradictorias manifestaciones con respecto a sus efectos justifican la necesidad de evaluar su efectividad para así regular la seguridad de su utilización. Para la valoración crítica del artículo se ha utilizado la herramienta propuesta por el “National Heart, Lung, and Blood Institute” para estudios experimentales prepost sin grupo control. [fragmento del texto]