23Board of Governors, State University System of Florida

Transcription

1 Revised January Board of Governors, State University System of Florida Request to Offer a New Degree Program (Please do not revise this proposal format without prior approval from Board staff) University of North Florida Spring 2016 University Submitting Proposal Proposed Implementation Term Brooks College of Health Name of College(s) or School(s) Anesthesiology Nursing Academic Specialty or Field School of Nursing Name of Department(s)/ Division(s) Doctor of Nursing Practice Complete Name of Degree Proposed CIP Code The submission of this proposal constitutes a commitment by the university that, if the proposal is approved, the necessary financial resources and the criteria for establishing new programs have been met prior to the initiation of the program. Date Approved by the University Board of Trustees President Date Signature of Chair, Board of Trustees Date Vice President for Academic Affairs Date Provide headcount (HC) and full-time equivalent (FTE) student estimates of majors for Years 1 through 5. HC and FTE estimates should be identical to those in Table 1 in Appendix A. Indicate the program costs for the first and the fifth years of implementation as shown in the appropriate columns in Table 2 in Appendix A. Calculate an Educational and General (E&G) cost per FTE for Years 1 and 5 (Total E&G divided by FTE). Implementation Timeframe Projected Enrollment (From Table 1) HC FTE E&G Cost per FTE 1 Projected Program Costs (From Table 2) E&G Funds Contract & Grants Funds Auxiliary Funds Total Cost Year ,289 1,137, ,137,192 Year Year Year Year ,116 1,137, ,137,192 Note: This outline and the questions pertaining to each section must be reproduced within the body of the proposal to ensure that all sections have been satisfactorily addressed. Tables 1 through 4 are to be included as Appendix A and not reproduced within the body of the proposals because this often causes errors in the automatic calculations.

2 Revised January 2015 INTRODUCTION I. Program Description and Relationship to System-Level Goals A. Briefly describe within a few paragraphs the degree program under consideration, including (a) level; (b) emphases, including concentrations, tracks, or specializations; (c) total number of credit hours; and (d) overall purpose, including examples of employment or education opportunities that may be available to program graduates. The proposed program is requesting to elevate the current Doctor of Nursing Practice, Nurse Anesthetist concentration (DNP-NAP) to a major. The University of North Florida, School of Nursing received Board of Governors approval to offer the DNP in This was done in keeping with the professional requirement to elevate the education of advanced practice nurses to the Doctoral level. This doctoral program has replaced the current MSN granting program that is now preparing nurses to enter the specialty of anesthesia. In accordance with the mandates of the American Association of Colleges of Nursing (AACN) and the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), and the recommendation of the Institute of Medicine (IOM), preparation for entry into roles in Advanced Practice Nursing will be required to take place at the doctoral level. UNF is the first SUS institution to accomplish this change for the specialty of nurse anesthesia. This proposal is developed to request the program be elevated from a concentration to a major. Initial accreditation for the DNP-NAP concentration was received in summer 2014 by the Council on Accreditation for Nurse Anesthesia Educational Programs (COA). The COA requires that a practice doctorate program be 36 months long and include didactic instruction in: Advanced Physiology/Pathophysiology (120 contact hours), Advanced pharmacology (90 contact hours) Basic and advanced principles in nurse anesthesia (120 contact hours) Research (75 contact hours) Advanced health assessment (45 contact hours) Additionally, the curriculum must also include the following subjects with no specific hour requirement: Human anatomy, chemistry, biochemistry, physics, genetics, acute and chronic pain management, radiology, ultrasound, anesthesia equipment, professional role development, chemical dependency and wellness, informatics, ethical and multicultural healthcare, leadership and management, business of anesthesia/practice management, health policy, healthcare finance, integration/clinical correlation. The Council on Collegiate Nursing Education, the accrediting agency for university based nursing educational programs, conducted an accreditation visit on February 2015 and had no compliance concerns with the program. The DNP-NAP requires 111 graduate credits. This program prepares graduates for entry into the specialty of anesthesiology nursing through eligibility to take the National Certification Examination and earn the designation of Certified Registered Nurse Anesthetist. The UNF School of Nursing has graduated 156 students at the Master s degree level, all have passed their certification examination and are currently employed in their specialty field, earning over $125,000. B. Please provide the date when the pre-proposal was presented to CAVP (Council of Academic Vice Presidents) Academic Program Coordination review group. Identify any concerns that the CAVP review group raised with the pre-proposed program and provide a brief narrative explaining how each of these concerns has been or is being addressed. The CAVP met on 2/6/2015 and no concerns were raised. C. If this is a doctoral level program please include the external consultant s report at the end of the proposal as Appendix D. Please provide a few highlights from the report and describe ways in which the report affected the approval process at the university. 2

3 Revised January 2015 The consultation report from Dr. John M. O Donnell, DrPH, MSN, CRNA is available in Appendix D. Dr. O Donnell serves as Chair & professor for the Department of Nurse Anesthesia at the University of Pittsburg in Pittsburg, PA. Dr. O Donnell has been a reviewer for the Council on Accreditation Nurse Anesthesia Educational programs (COA) since 1999 and Chair Reviewer since In his report, Dr. O Donnell states that resources appear to be adequate, The Program director is a respected, senior member of the national Nurse Anesthesia educational community. His work in the development of Nurse Anesthesia Educational Program Curricula over the past three decades is well recognized at the national level as he as known as an early adopter and innovator The team of faculty he has assembled to educate and mentor in the UNF DNP-NAP program for Nurse Anesthetists is remarkable in educational, scientific and clinical expertise. Importantly, the faculty continue to practice in their respective fields. He further expands that he sees no weaknesses noted in allowing the transition from an area of concentration to a Major within the School of Nursing and notes that the program is already performing the activities typically conducted by a Major. Dr. O Donnell also states that this transition establishes the UNF Nurse Anesthesia Program as an early adopter and thought leader throughout the state. In summary, my analysis concludes that the proposal to transition the UNF Nurse Anesthesia Program from an area of concentration to a Major within the School of Nursing is a prudent and well-conceived initiative Chief among these benefits is that the UNF DNP-will achieve recognition within the institution and benefit from an enhanced regional and national reputation. This enhanced reputation will assist the program in successfully competing with other high quality programs nationally in a variety of areas. D. Describe how the proposed program is consistent with the current State University System (SUS) Strategic Planning Goals. Identify which specific goals the program will directly support and which goals the program will indirectly support (see link to the SUS Strategic Plan on the resource page for new program proposal). The SUS Plan states that it will: provide leadership that will find solutions to the educational, economic, and societal challenges of the coming decades, the state universities will continue to: Deliver knowledge to advance the health, welfare, cultural enrichment, and economy through community and business engagement and service The proposed program is fully aligned with this stated plan. In addition to proving direct patient care, graduates of this program as holders of a doctoral degree will be qualified to also act as nursing faculty in Florida. This role is an area of critical shortage. According to the American Association of Colleges of Nursing (AACN) a shortage of faculty is a primary obstacle to expanding the nation s nursing workforce and meeting care demand. In 2014, AACN reported that over a thousand qualified applicants were not offered admission to doctoral (1,844) programs due to a faculty shortage as well as other resource constraints. Not only is there a current shortage, but is will be exacerbated by the fact that the average age of nursing faculty in Florida is now 54 years of age. The specific relationship between SUS Goals and the UNF DNP-NAP is described in the SUS 2015 Goals chart. SUS Goals EXCELLENCE PRODUCTIVITY STRATEGIC PRIORITIES TEACHING & LEARNING SCHOLARSHIP, RESEARCH, & INNOVATION The specialty of anesthesia nursing is viewed as a highly competitive, and academically rigorous program bring attention and recognition to the university. For the preceding three years the UNF NAP at the MSN level has produced for research posters accepted at the AANA State of the Science Congress than any other university. 3 This program will produce doctorally prepared nurse specialists at an extremely favorable faculty: student ratio. The UNF NAP is already the recognized leader in research production. Further increase is unlikely without a funding increase beyond what is This program will increase by the number of doctorally prepared nursing majors, clearly in the STEM area, and also in health, a strategic area of emphasis. Creating the NAP to a separate DNP major may well increase opportunities for external support of scholarship and research activities.

4 Revised January 2015 COMMUNITY & BUSINESS ENGAGEMENT Currently eight community clinical sites cooperate in the clinical instruction of these students. Not being an academic medical center, there is a strong relationship between UNF and our community partners. Last year alone, UNF NAP students provided over 37,700 hours of anesthesia care to medically underserved populations throughout Florida anticipated. Community leaders are now, and will be increasingly, involved in student selection and clinical education and any future curricular changes will be based on community and professional needs. The UNF NAP will increase the nurse anesthesia work force by practitioners annually. E. If the program is to be included in a category within the Programs of Strategic Emphasis as described in the SUS Strategic Plan, please indicate the category and the justification for inclusion. The Programs of Strategic Emphasis Categories: 1. Critical Workforce: Education Health Gap Analysis 2. Economic Development: Global Competitiveness 3. Science, Technology, Engineering, and Math (STEM) Please see the Programs of Strategic Emphasis (PSE) methodology for additional explanations on program inclusion criteria at the resource page for new program proposal. This proposed program, designed to prepare advance practice nurses specializing in anesthesiology, should be included in the Critical Workforce:Health category. Data in section II deals with specific figures on need. It should be noted that 28% of CNRA are within ten years of retirement age. F. Identify any established or planned educational sites at which the program is expected to be offered and indicate whether it will be offered only at sites other than the main campus. Didactic activities of the program will continue to be based at the UNF campus. The university has the equipment required to broadcast classes with live interactive television via tele-video conferencing (TVC) to clinical sites in order to minimize student travel back to the UNF campus in Jacksonville in order to attend classes. This equipment is currently utilized in the program and has proven to be successful. Clinical portions of the program will continue to be accomplished at the eight community-based clinical facilities currently being used. These include: UF Health, Jacksonville Mayo Clinic, Jacksonville St. Vincent s Medical Center, Jacksonville U.S. Naval Hospital, NAS, Jacksonville Garcia Facial Surgery Institute, Neptune Beach Tampa General Hospital, Tampa Flagler Hospital, St. Augustine Halifax Medical Center, Daytona 4

5 Revised January 2015 INSTITUTIONAL AND STATE LEVEL ACCOUNTABILITY II. Need and Demand A. Need: Describe national, state, and/or local data that support the need for more people to be prepared in this program at this level. Reference national, state, and/or local plans or reports that support the need for this program and requests for the proposed program which have emanated from a perceived need by agencies or industries in your service area. Cite any specific need for research and service that the program would fulfill. There is currently a shortage of nurse anesthetists and preparation of these nurse specialists is unlikely to keep pace with the substantial population and public policy-generated growth in demand for service, even in the face of productivity improvements and innovation. (Shubert, A. [2012] Status of the anesthesia workforce in 2011: evolution during the last decade and future outlook. Anes Analg Aug;115(2):407-27) According to the American Association of Nurse Anesthetists this is compounded by the fact that 55% of nurse anesthetists are over age 50. (AANA Annual Report, 2011) A report by the RAND Corporation found that there was indeed evidence of a shortage of anesthesiologists in the workforce. (The RAND Corporation [2013] The Anesthesiologist Workforce in 2013.) In a white paper on the subject of workforce number, the American Association of Nurse Anesthetists states that: Demand for nurse anesthesia services is anticipated to continue growing as the U.S. population ages. ( Anesthesia-Workforce-Development.pdf, accessed 10 April 2015) These data at the national level coincide with the findings in our local area in that all nurse anesthesia graduates from the UNF MSN Nurse Anesthesia program are employed, hospitals actively seek our graduates and applicants to the UNF MSN Nurse Anesthesia program come from a nationwide pool. Many of these students come from outside of Florida, after graduation they reside and work in the state. B. Demand: Describe data that support the assumption that students will enroll in the proposed program. Include descriptions of surveys or other communications with prospective students. In each of the seven years that UNF has had an MSN Nurse Anesthesia program the number of fully qualified applicants has far exceeded the number of available seats in the program. Applications, Enrollments and Graduates for UNF NAP program over 5 years Year # of seats # applicants # accepted # enrolled # graduated C. If substantially similar programs (generally at the four-digit CIP Code or 60 percent similar in core courses), either private or public exist in the state, identify the institution(s) and geographic location(s). Summarize the outcome(s) of communication with such programs with regard to the potential impact on their enrollment and opportunities for possible collaboration (instruction and research). In Appendix C, provide data that support the need for an additional program. The following SUS institutions have MSN Nurse Anesthesia programs: FIU, USF, FGCU. FSU will shortly begin operation of a program granting the MS in Nurse Anesthesia degree. Although this program has been accredited by the COA, the program is not housed within the FSU College of Nursing, so it is not considered a degree in nursing and is not accredited by the CCNE (Council on Colligate 5

6 Revised January 2015 Nursing Education). FIU is exploring the possibility of establishing a practice doctorate as entry into the profession, however, no curriculum has yet been formalized, and no application for accreditation has been submitted to the COA. Private institutions that have either and MS or MSN Nurse Anesthesia program are Barry University, Adventist University of Health Sciences, Gooding Institute of Nurse Anesthesia, and, Wolford College. None of these institutions have announced plans to initiate a BSN to DNP program in nurse anesthesia. Only the University of Miami has begun a BS to DNP program in nurse anesthesia. After review of the submitted documentation, The Council on Accreditation of Nurse Anesthesia Educational Programs (COA), the USDoE designated accrediting agency for nurse anesthesia education, granted accreditation to the UNF DNP-NAP program in the summer of Appendix C includes letters of support. Dr Nathaniel Apatov, Program Director, Nurse Anesthesia Program at Old Dominion University, and Mr Nikolas Kalynych, Co-Founder and Managing Partner for Sunbelt Anesthesia Services, both mention the added skills these graduates will have and the increased market value they bring to the profession and to health care. In addition, Dr Apatov did state how the DNP makes these graduates marketable as future faculty. Dr McFadden, Dean & Professor of Anesthesiology at Barry University also shared his support for this proposal. He further states the outcomes of this proposal will help meet the shortage needs in clinical anesthesia practice and education. D. Use Table 1 in Appendix A (1-A for undergraduate and 1-B for graduate) to categorize projected student headcount (HC) and Full Time Equivalents (FTE) according to primary sources. Generally undergraduate FTE will be calculated as 40 credit hours per year and graduate FTE will be calculated as 32 credit hours per year. Describe the rationale underlying enrollment projections. If students within the institution are expected to change majors to enroll in the proposed program at its inception, describe the shifts from disciplines that will likely occur. Appendix A, Table 1-B Grad Enrollment demonstrates a pattern of enrollment which we have seen over the past five years. Year 1 only constitutes new enrollees while years 2 and 3 constitute the additional cohorts. The students in the DNP-NAP program are admitted in cohorts and take courses as such. Each year, 25 students will be admitted and will remain in the program for 3 years or 9 semesters. As a second cohort of 25 students is admitted, the number of enrollees increases to 50. The third year another cohort of 25 students is admitted, 50 students are continuing on, for a total of 75 students enrolled in the program. After year three, the number of students enrolled in the program will maintain at 75, although only will be admitted each year. Students are admitted directly post BSN into the DNP program. The number has been consistent in the past 5 years, demonstrating the need remains constant. The number of FTEs is calculated by cohort as each cohort enrolls in a different number of credits per year. Year one students enroll in 38 credits, as well as year two. During year three students enroll in 36 credits. E. Indicate what steps will be taken to achieve a diverse student body in this program. If the proposed program substantially duplicates a program at FAMU or FIU, provide, (in consultation with the affected university), an analysis of how the program might have an impact upon that university s ability to attract students of races different from that which is predominant on their campus in the subject program. The university s Equal Opportunity Officer shall review this section of the proposal and then sign and date Appendix B to indicate that the analysis required by this subsection has been completed. There is no program comparable to the proposed program at either FAMU or FIU. As stated previously FIU, although offering an MSN in Nurse Anesthesia, it currently does not offer a practice doctorate as entry into the profession. The current UNF NAP-DNP program has been successful at maintaining a diverse student body. National percentage of diversity for Nurse Anesthetists is 7%. UNF has an average of 26.9% well above 6

7 Revised January 2015 the national average. The UNF NAP-DNP program has monitored progress of its diversity presence with support of the HRSA grants awarded to the program. The results since 2008 are presented in the table below: 7

8 Revised January 2015 Diversity of students from UNF NAP program over Year M/F White Hispanic African American Asian Native American Hawaiian/ Pacific islander Total % Minority / % / % / % / % / % / % / % / % Several steps will be taken to maintain and sustain a diverse student body as an inherent part of this competitive and successful program. Foremost will be the need to ensure funds are allocated to implement broad-based, comprehensive marketing, outreach and recruitment processes. Examples include the following: 1. Conduct recruitment activities nationally and in Florida where underrepresented populations are available in the nurse anesthesia specialization. This will include speaking at local and national meetings comprising affinity groups, and promoting the degree in their respective newsletters, blogs, social media and periodicals. 2. Participate in the Diversity in Nurse Anesthesia Mentorship Program founded by Wallena Gould, Ed.D., CRNA ( 3. Utilize diversity recruitment resources such as the Florida Alliance for Health Professions Diversity. 4. Seek scholarships and grants specific to increasing underrepresented groups and promoting diversity within the profession. Past grants awarded to UNF NAP program include: USPHS, HRSA grant # 1D09 HP Increasing diversity, cultural competence and clinical skills in a Nurse Anesthetist Program (2008). and USPHS, HRSA grant # 1D09 HP Expanding a Culturally Diverse Nurse Anesthesia Program (2002). III. Budget A. Use Table 2 in Appendix A to display projected costs and associated funding sources for Year 1 and Year 5 of program operation. Use Table 3 in Appendix A to show how existing Education & General funds will be shifted to support the new program in Year 1. In narrative form, summarize the contents of both tables, identifying the source of both current and new resources to be devoted to the proposed program. (Data for Year 1 and Year 5 reflect snapshots in time rather than cumulative costs.) The doctoral program already admitted the first cohort of students in January These students will remain in the program for three entire years, until December All funds from prior MSN-NAP program have been reallocated to current DNP-NAP program. Faculty salaries will remain the same, as well as the salary for A & P staff. Students will be paying additional fees to cover direct expenses for the students. These fees are assessed per student and are being requested as an agency fee as these costs are dependent on the vendors. Please refer to Appendix F for a listing of items to be paid out of agency fees. This clear designation of the program will allow for the development of an operating budget for the program as currently fees have been used for operations. 8

9 Revised January 2015 This proposal is requesting an adjustment in student tuition and fees. The proposed amount was derived by combining the tuition and all possible associated fees for the program. Some of these associated fees include travel to off-site locations (Tampa and General and Halifax Hospital) in order to have a faculty perform fist hand evaluations of students. One unique aspect of the program is the global health perspective. This is accomplished through the development of partnerships with Paracelseus University in Austria and the University of Amsterdam. This global perspective allows for renowned educators from both institutions to come to UNF to lecture the students and to work collaboratively with students on their research projects. It also allows for students to understand healthcare in other regions in order to incorporate concepts into the care they are able to provide here in the US. Proposed Tuition and Fees Proposed tuition $48, $3200 $51, B. Please explain whether the university intends to operate the program through continuing education on a cost-recovery basis, seek approval for market tuition rate, or establish differentiated graduate-level tuition. Provide a rationale for doing so and a timeline for seeking Board of Governors approval, if appropriate. Please include the expected rate of tuition that the university plans to charge for this program and use this amount when calculating cost entries in Table 2. The program is proposing a differentiated graduate-level tuition. We are hoping the new major will assist with this differentiation. The expenses for the Nurse Anesthetist program are higher than those for other programs at the University, therefore the differentiated graduate-level tuition is appropriate. Current in-state graduate tuition at the University of North Florida is $ Differentiated graduatelevel tuition is proposed at $ The below chart shows a comparison to other SUS Nurse Anesthesia Programs as posted on their websites. Please note differences in degrees and credits for each program. Comparison of SUS NAP programs Tuition (as posted and available on websites) University Credit hours Tuition Fees Tuition & Fees IS Tuition OOS USF (Market Based) 72 (MSN) $800 (CH) 0 $57,600 $57,600 FIU (Professional) 101 (MSN + DNP) $77,509 $128,647 FGCU 81 (MSN) $30, x7 $40,744 $115,853 UNF new tuition 111 (DNP) $48, $3200 $51, $98,000 w/fees We would also like to propose the OOS tuition for the program be set at $855.00/per credit or $94,800 plus the $3200 agency account fees for a total of $98,000. We think it is important to bring students from out of state who might choose to stay in Florida C. If other programs will be impacted by a reallocation of resources for the proposed program, identify the impacted programs and provide a justification for reallocating resources. Specifically address the potential negative impacts that implementation of the proposed program will have on related undergraduate programs (i.e., shift in faculty effort, reallocation of instructional resources, reduced enrollment rates, greater use of adjunct faculty and teaching assistants). Explain what steps will be taken to mitigate any such impacts. Also, discuss the potential positive impacts that the proposed program might have on related undergraduate programs (i.e., increased undergraduate research opportunities, improved quality of instruction associated with cutting-edge research, improved labs and library resources). This doctoral program has replaced the current MSN Program preparing nurse anesthetists. All faculty and fiscal resources currently dedicated to the MSN Program have been redirected to the new DNP-NAP Program as the MSN Program producing nurse anesthetists is now being phased out. No other programs will be affected. 9

10 Revised January 2015 D. Describe other potential impacts on related programs or departments (e.g., increased need for general education or common prerequisite courses, or increased need for required or elective courses outside of the proposed major). The program will produce no impact on other departments. E. Describe what steps have been taken to obtain information regarding resources (financial and in-kind) available outside the institution (businesses, industrial organizations, governmental entities, etc.). Describe the external resources that appear to be available to support the proposed program. In the current funding climate there is little possibility to secure external funding to support the operation of the program. However, the UNF School of Nursing has a substantial record of success is securing federally funded traineeships designed specifically to support nurse anesthesia education. Successfully funded grants include: USPHS, HRSA Nurse Anesthesia Traineeship grant # A22HP27147 $43,544 ( ) USPHS, HRSA Nurse Anesthesia Traineeship grant # A22HP26019 $36,500 ( ) USPHS, HRSA Nurse Anesthesia Traineeship grant # A22HP24514 $32,336 ( ) USPHS, HRSA Nurse Anesthesia Traineeship grant # A22HP21706 $15,800 ( ) USPHS, HRSA AEN grant # 1D09 HP rd yr funded at $476,680 ( ) USPHS, HRSA Nurse Anesthesia Traineeship grant $2,683 ( ) USPHS, HRSA AEN grant # 1D09 HP nd yr funded at $481,589 ( ) USPHS, HRSA Nurse Anesthesia Traineeship grant $2,621 ( ) USPHS, HRSA grant # 1D09 HP st yr funded at $618,150 ( ) USPHS, HRSA grant # 1D09 HP Increasing diversity, cultural competence and clinical skills in a Nurse Anesthetist Program Approved and funded (estimated at $1.6M). USPHS, HRSA grant # 1D09 HP rd yr funded at $363,639 ( ) USPHS, HRSA Nurse Anesthesia Traineeship grant $22,193 ( ) USPHS, HRSA grant # 1D09 HP rd yr funded at $349,192 ( ) USPHS, HRSA Nurse Anesthesia Traineeship grant $7,042 ( ) USPHS, HRSA grant # 1D09 HP st yr funded at $435,159 ( ) USPHS, HRSA grant # 1D09 HP Expanding a Culturally Diverse Nurse Anesthesia Program Approved and funded (estimated at $1.15M). IV. Projected Benefit of the Program to the University, Local Community, and State Use information from Tables 1 and 2 in Appendix A, and the supporting narrative for Need and Demand to prepare a concise statement that describes the projected benefit to the university, local community, and the state if the program is implemented. The projected benefits can be both quantitative and qualitative in nature, but there needs to be a clear distinction made between the two in the narrative. Quantitatively, the benefits will be increased FTE from doctoral level clinical scholars and subsequent increased productivity and policy impacts that result from student-faculty based clinical outcomes projects. The American Association of Nurse Anesthetists and the Institute of Medicine are both promoting doctoral level training for advanced nurse practitioners. Currently there are no other DNP programs in Florida preparing nurses to become nurse anesthetists. It is expected that with an aging population, and the introduction of increased insurance coverage through the Affordable Care Act the need for nurses, particularly nurse anesthetists, will increase at a rate faster than the average for other health-related occupations. Florida s rate of chronic disease, and increasingly aged and multicultural population make advanced level practice in nurse anesthesia a health imperative. The projected benefit to the university, local community, and the state with the implementation of the program is, qualitatively, recognition as a national model for advanced practice doctoral level education in evidence-based anesthesiology nursing practice. 10

11 Revised January 2015 The DNP curriculum is designed to enable students to develop the knowledge and skills, leadership, outcome measures and evidence analysis skills necessary to solve the anesthesiology and pain management issues affecting their communities, be they institutional, local, state, or national. The core content area courses, or core requirements, include in-depth learning about the physiological and pharmacologic basis of anesthesia; advanced analysis of current critical topics; further skill development in clinical and communication techniques; and detailed study in evidence-based work and outcome measures (psychomotor). In addition, the student will participate in a Clinical Residency tailored to the student s special interests. This residency will follow the guidelines identified by the profession. Faculty will work individually with students to help them identify a strategy for effective learning at this advanced level. Qualitatively, this individualized approach to helping students tailor the work to their interests and needs provides advanced practice doctoral professionals who are better prepared to work addressing the health needs of the institution and the communities they serve. Historically nurse anesthetists have been the sole providers of anesthesia care in underserved and rural areas. Medically Underserved Areas/Populations (MUA/Ps) are areas/populations the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) has designated as facing barriers to accessing health care. There are 127 MUA/Ps in Florida. V. Access and Articulation Bachelor s Degrees Only A. If the total number of credit hours to earn a degree exceeds 120, provide a justification for an exception to the policy of a 120 maximum and submit a separate request to the Board of Governors for an exception along with notification of the program s approval. (See criteria in Board of Governors Regulation 6C-8.014) The proposal is for a doctoral program, as such, section V is not applicable. Not applicable. B. List program prerequisites and provide assurance that they are the same as the approved common prerequisites for other such degree programs within the SUS (see link to the Common Prerequisite Manual on the resource page for new program proposal). The courses in the Common Prerequisite Counseling Manual are intended to be those that are required of both native and transfer students prior to entrance to the major program, not simply lower-level courses that are required prior to graduation. The common prerequisites and substitute courses are mandatory for all institution programs listed, and must be approved by the Articulation Coordinating Committee (ACC). This requirement includes those programs designated as limited access. If the proposed prerequisites are not listed in the Manual, provide a rationale for a request for exception to the policy of common prerequisites. NOTE: Typically, all lower-division courses required for admission into the major will be considered prerequisites. The curriculum can require lower-division courses that are not prerequisites for admission into the major, as long as those courses are built into the curriculum for the upper-level 60 credit hours. If there are already common prerequisites for other degree programs with the same proposed CIP, every effort must be made to utilize the previously approved prerequisites instead of recommending an additional track of prerequisites for that CIP. Additional tracks may not be approved by the ACC, thereby holding up the full approval of the degree program. Programs will not be entered into the State University System Inventory until any exceptions to the approved common prerequisites are approved by the ACC. C. If the university intends to seek formal Limited Access status for the proposed program, provide a rationale that includes an analysis of diversity issues with respect to such a 11

12 Revised January 2015 Not applicable. Not applicable. designation. Explain how the university will ensure that Florida College System transfer students are not disadvantaged by the Limited Access status. NOTE: The policy and criteria for Limited Access are identified in Board of Governors Regulation 6C Submit the Limited Access Program Request form along with this document. D. If the proposed program is an AS-to-BS capstone, ensure that it adheres to the guidelines approved by the Articulation Coordinating Committee for such programs, as set forth in Rule 6A (see link to the Statewide Articulation Manual on the resource page for new program proposal). List the prerequisites, if any, including the specific AS degrees which may transfer into the program. INSTITUTIONAL READINESS VI. Related Institutional Mission and Strength A. Describe how the goals of the proposed program relate to the institutional mission statement as contained in the SUS Strategic Plan and the University Strategic Plan (see link to the SUS Strategic Plan on the resource page for new program proposal). The mission of the SUS is to provide undergraduate, graduate and professional education, research, and public service of the highest quality through a coordinated system of institutions of higher learning, each with its own mission and collectively dedicated to serving the needs of a diverse state and global society. The mission of the University of North Florida is The University of North Florida fosters the intellectual and cultural growth and civic awareness of its students, preparing them to make significant contributions to their communities in the region and beyond. At UNF, students and faculty engage together and individually in the discovery and application of knowledge. UNF faculty and staff maintain an unreserved commitment to student success within a diverse, supportive campus culture This proposal, to elevate the DNP-NAP from a concentration to a Major directly relates to both of these missions (UNF & SUS). The education of graduate prepared professionals with an understanding of the needs of a diverse state and preparing them to make significant contributions to society is embedded in the curriculum. Preparing the NAP graduates at the highest degree possible is definitely aligned with these missions. Although four other SUS institutions also offer the Nurse Anesthetist program, UNF will be the only one at this point to offer an entry into practice program with a designated focus on the roles of the DNP. This role focuses on Evidence-based Practice; Advocacy; Interprofessional Collaboration; Scientific Underpinnings for Practice; Information Systems and Patient Care Technology; and Advanced Nursing Practice. UNF has a long history of preparing advanced practice nurses at the graduate level. The initial program in Nurse Anesthesia graduated the first class with an MSN degree in The advancement of that initial program to the doctoral level is mandated by our accrediting and certifying agencies. The current DNP-NAP curriculum is currently being offered as a concentration in the DNP program. This proposal intends to elevate the current program from a concentration to a major. B. Describe how the proposed program specifically relates to existing institutional strengths, such as programs of emphasis, other academic programs, and/or institutes and centers. In 2005, the first Flagship Program designated by UNF was the School of Nursing. The School of Nursing has reached a level of national recognition for the advances made in the area of community involvement with nursing education. The well recognized and close partnerships that have been developed with community agencies are preparing UNF nursing graduates to practice in a wider variety 12

13 Revised January 2015 of settings rather than merely as a member of hospital staff. As healthcare is evolving to a more community based system of care, UNF graduates are well positioned to be proactive and leaders related to this crucial paradigm shift. In 2014 alone, Nurse Anesthetist Program students provided over 37,700 hours of anesthesia care to medically underserved populations throughout Florida. C. Provide a narrative of the planning process leading up to submission of this proposal. Include a chronology in table format of the activities, listing both university personnel directly involved and external individuals who participated in planning. Provide a timetable of events necessary for the implementation of the proposed program. Between , faculty worked through the faculty governance process to create the revised curriculum and program of study. The program of study was developed through the SON Faculty Organizational structure via the Graduate Faculty Committee; and then submitted to the UNF Faculty Association, Academic Programs Committee, with final approval spring SON committees involved in planning for the transition from the MSN to the DNP include the Graduate Curriculum Committee, Graduate Admission, Progression and Graduation Committee (GAPG), and the SON Evaluation Committee. Planning for the implementation and matriculation of students in the DNP-Nurse Anesthesia Program was for initial enrollment in Spring The Director of the SON submitted a substantive change notification to CCNE fall A substantive change was submitted to the Council on Accreditation of Nurse Anesthesia Programs(COA) for the BSN to DNP Nurse Anesthesia Program, with approval granted summer In January 2015, the first cohort of DNP-NAP students was admitted to UNF. Planning Process Date Participants Planning Activity Graduate curriculum committee Developed curriculum for the DNP-NAP University Academic Programs Committee Approval of program Spring 2014 Graduate curriculum committee with NAP Revision of courses as needed faculty Summer 2015 University Academic Programs committee Submit proposal to elevate from concentration to major Events Leading to Implementation Date Implementation Activity Spring 2014 Accreditation by COA Summer 2014 Change in website and selection of first cohort January 2015 Enrollment of first cohort of students Summer 2015 Submission for elevation from concentration to degree in May 2015 VII. Program Quality Indicators - Reviews and Accreditation Identify program reviews, accreditation visits, or internal reviews for any university degree programs related to the proposed program, especially any within the same academic unit. List all recommendations and summarize the institution's progress in implementing the recommendations. In 2007, the School of Nursing received approval from the Board of Governors to offer a DNP. Later in 2010, after submission of a self-study, and the conduct of an on-site visit, the Commission of Collegiate Nursing Education (CCNE) granted approval to UNF to award the Doctor of Nursing Practice degree. In 2014 the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) approved the conversion of the UNF MSN Nurse Anesthesia Program to the DNP level. No 13

14 Revised January 2015 recommendation were offered by either accrediting agency and UNF is now fully approved by all appropriate external agencies to offer the DNP degree at the completion of the entry level program to prepare nurse anesthetists. In 2015, UNF hosted a second Commission of Collegiate Nursing Education (CCNE) visit to reaccredit the DNP program including the DNP-NAP cohort. This visit, although no formal reports issued at this time, resulted in a positive visit. The visitors reported the School of Nursing met all accreditation standards and had no recommendations. VIII. Curriculum A. Describe the specific expected student learning outcomes associated with the proposed program. If a bachelor s degree program, include a web link to the Academic Learning Compact or include the document itself as an appendix. Graduate are expected to meet educational objectives that include psychomotor skills, cognitive (interpretive and problem solving) and behavioral skills. These skills are exemplified by the following abilities: a. Patient safety is demonstrated by the ability of the graduate to: 1. Be vigilant in the delivery of patient care. 2. Protect patients from iatrogenic complications. 3. Participate in the positioning of patients to prevent injury. 4. Conduct a comprehensive and appropriate equipment check. 5. Utilize standard precautions and appropriate infection control measures. b. Individualized perianesthetic management is demonstrated by the ability of the graduate to: 1. Provide care throughout the perianesthetic continuum. 2. Use a variety of current anesthesia techniques, agents, adjunctive drugs, and equipment while providing anesthesia. 3. Administer general anesthesia to patients of all ages and physical conditions for a variety of surgical and medically related procedures. 4. Provide anesthesia services to all patients, including trauma and emergency cases. 5. Administer and manage a variety of regional anesthetics. 6. Function as a resource person for airway and ventilatory management of patients. 7. Possess current advanced cardiac life support (ACLS) recognition. 8. Possess current pediatric advanced life support (PALS) recognition. 9. Deliver culturally competent perianesthetic care throughout the anesthesia experience. c. Critical thinking is demonstrated by the graduate s ability to: 1. Apply theory to practice in decision-making and problem solving. 2. Provide nurse anesthesia care based on sound principles and research evidence. 3. Perform a preanesthetic assessment and formulate an anesthesia care plan for patients to whom they are assigned to administer anesthesia. 4. Identify and take appropriate action when confronted with anesthetic equipment-related malfunctions. 5. Interpret and utilize data obtained from noninvasive and invasive monitoring modalities. 6. Calculate, initiate, and manage fluid and blood component therapy. 7. Recognize and appropriately respond to anesthetic complications that occur during the perianesthetic period. 14

15 Revised January Pass the Council on Certification of Nurse Anesthetists (CCNA) certification examination in accordance with CCNA policies and procedures. d. Communication skills are demonstrated by the graduate s ability to: 1. Effectively communicate with all individuals influencing patient care. 2. Utilize appropriate verbal, nonverbal, and written communication in the delivery of perianesthetic care. e. Professional role is demonstrated by the graduate s ability to: 1. Participate in activities that improve anesthesia care. 2. Function within appropriate legal requirements as a registered professional nurse, accepting responsibility and accountability for his or her practice. 3. Interact on a professional level with integrity. 4. Teach others. 5. Participate in continuing education activities to acquire new knowledge and improve his or her practice. B. Describe the admission standards and graduation requirements for the program. In order to be admitted to this program an applicant must be a Registered Nurse, hold a BSN degree, have two years of critical care nursing experience and have acceptable GRE or MAT scores, and successfully complete an interview. Graduation requires successful completion of the established curriculum and completion of the number of anesthetic cases as required by the COA. C. Describe the curricular framework for the proposed program, including number of credit hours and composition of required core courses, restricted electives, unrestricted electives, thesis requirements, and dissertation requirements. Identify the total numbers of semester credit hours for the degree. The curricular framework for this program is derived from the requirements for nurse anesthesia graduate education at the doctoral level as specified by the Council on Accreditation of Nurse Anesthesia Educational Programs. It meets those requirements so that graduates will be qualified to take the National Certification Examination to become a Certified Registered Nurse Anesthetist. In addition, the DNP program was designed using AACN s Essentials of Doctoral Education for Advanced Nursing Practice (2006). All courses listed are required. This program, as all programs resulting in the award of the DNP degree, requires a Capstone Project in which the student examines a particular clinical problem and brings the best evidence to bear in the implementation of a plan to solve the identified problem. The program is comprised of 111 semester hours delivered in nine continuous semesters. There are no electives. The program was developed based on standards set forth by the accreditation agencies and by the American Association of Colleges of Nursing Essentials for Doctoral education in addition to the Standards delineated in the Nurse Anesthesia professional Practice Manual D. Provide a sequenced course of study for all majors, concentrations, or areas of emphasis within the proposed program. Major: Nursing Concentration: Nurse Anesthetist Degree: Doctor of Nursing Practice 15

16 Revised January st Semester (12 credits) Spring semester NGR6740 Role Dev in Adv Practice Nsg (3 Credits) NGR7871 Health Informatics for AP (3 Credits) NGR6673 Prin Epidem for Adv Prac (3 Credits) NGR6892 Pub Pol Impl Adv Prac (3 Credits) 2nd Semester (10 credits) Summer semester NGR7843 Stat Interp for Adv Prac (3 Credits) NGR5110 Theory Framework for Practice (3 Credits) NGR5003C Health Assessment/Diagnostics (4 Credits) 3rd Semester (16 credits) Fall semester NGR5172 Pharmacotherapeutics (3 Credits) NGR5141 Advanced Pathophysiology (3 Credits) NGR6421 Prin of Anesth Nursing I (2 Credits) NGR6400 Chem and Phy Anes Nsg-I (2 Credits) NGR6460 Pharm Anes Nsg I (1 Credit) NGR5810 Research Methods for EBP (3 Credits) NGR6431L Anesth Nursing Practicum I (1 Credit) NGR6493 Technology in Anesth Nursing (1 Credit) 4th Semester (15 credits) Spring semester NGR6404 Adv Biosc Anes Nsg I (3 Credits) NGR6422 Prin of Anesth Nursing II (3 Credits) NGR6461 Pharm Anes Nsg II (2 Credits) NGR6401 Chem and Phy Anes Nsg-II (1 Credit) NGR7768 Role Devel in ANP (3 Credits) Course title will change to Advanced Practice Nursing Role Transition effective for spring 2016 semester. NGR6432L Anesth Nursing Practicum II (3 Credits) 5th Semester (11 credits) Summer semester NGR6490 Regional Anesthesia (2 Credits) NGR6423 Prin of Anesth Nursing III (2 Credits) NGR7850 Evidence Based Practice I (3 Credits) NGR6433L Anesth Nursing Practicum III (6 Credits) 6th Semester (12 credits) Fall semester NGR7851 Evidence Based Practice II (3 Credits) NGR6405 Adv Biosc Anesth Nursing II (3 Credits) NGR6434L Anesth Nursing Practicum IV (8 Credits) 7th Semester (13 credits) Spring semester NGR6424 Prin of Anesth Nursing IV (2 Credits) NGR6494 Adv Mod Pain Mgt (3 Credits) NGR6435L Anesth Nursing Practicum V (8 Credits) NGR7974 Doctoral Project (1-6 Credits) 8th Semester (11 credits) Summer semester NGR6894 Global Health Care and Culture (3 Credits) NGR7974 Doctoral Project (1-6 Credits) NGR7946 Residency in ANP (3-9 Credits) 9th Semester (11 credits) Fall semester NGR6491 Adv Anes Nsg Sem (3 Credits) NGR7974 Doctoral Project (1-6 Credits) 16

17 Revised January 2015 NGR7946 Residency in ANP (3-9 Credits) E. Provide a one- or two-sentence description of each required or elective course. NGR6740 Role Dev in Adv Practice Nsg This course includes topics associated with advanced practice nursing. Students will develop and implement evidence-based practice. Emphasis is on developing effective communication and collaborative skills for the development and implementation of Interprofessional teams, practice models, peer review, practice guidelines, health policy, standards of care, and/or scholarly endeavors. NGR7871 Health Informatics for AP This course includes topics concerning the role played by informatics in Advanced Practice nursing. Topic such as quality improvement and data mining are presented. The impact of automated data management through advances in information technology, health care information systems, and tele-health are explored. NGR6673 Prin Epidem for Adv Prac This course covers the potential influence of advanced practice nurses upon factors affecting the health and illness of populations, and serves as the foundation and logic of evidence based interventions made in the interest of health and safety. NGR6892 Pub Pol Impl Adv Prac The origins of policy created through legislative and administrative action will be considered. Strategies for policy creation, implementation, evaluation and change will be examined from the viewpoint of advanced practice. NGR7843 Stat Interp for Adv Prac This course covers the use and interpretation of statistical methods commonly used in health care studies. The advantages and disadvantages of specific techniques will be considered along with various examples of computer based statistical packages. NGR5110 Theory Framework for Practice Critique, evaluate and utilize a wide range of theories from nursing and other sciences. Emphasis on synthesis of theories to develop a conceptual framework for the delivery of advanced nursing care. NGR5003C Health Assessment/Diagnostics This course focuses on development and proficiency in assessment and interview skills in obtaining health history and physical examination. Identification of abnormal findings is emphasized. Use of laboratory and diagnostic data to diagnose common uncomplicated health problems and acute illnesses is included. NGR5172 Pharmacotherapeutics This course will review commonly prescribed drugs including pharmacokinetics, actions, uses, side effects, contraindications, preparing written prescriptions, safety, cost effectiveness, legal, requirements, and patient education. NGR5141 Advanced Pathophysiology This course will include an advanced study of the normal physiologic and pathologic mechanisms of disease over the life span. Clinical application of pathophysiologic disorders is emphasized NGR6421 Prin of Anesth Nursing This course is a broad field orientation to advanced nursing practice. Study the area of pre, intra, and postanesthesia planning, monitoring, and record keeping are included. 17

18 Revised January 2015 NGR6400 Chem and Phy Anes Nsg-I Detailed study of the biochemical and physical principles, which apply to physiology, pharmacology, and anesthesia equipment. Emphasis is placed on biochemistry and physics of gases and vapors. NGR6460 Pharm Anes Nsg-I This course covers pharmacology of drugs affecting the autonomic nervous system as well as anesthetic agents. Administration and doses of the adjunctive drugs are included. NGR5810 Research Methods for EBP This course includes information related to research methods and evidence-based practice. The focus is on application of scientific knowledge to advanced practice. The emphasis is on skill development in critiquing, synthesizing and generating research evidence to address specific nursing practice questions. NGR6431L Anesth Nursing Practicum I This experience is an introduction to the clinical art and science of anesthesiology nursing. It introduces the clinical component of the anesthesia management techniques. This includes clinical practice. NGR6493 Technology in Anesth Nursing Use and care of anesthesia equipment (mechanical and electronic) are discussed. Computers and their use in anesthesia are also included. NGR6404 Adv Biosc Anes Nsg I This is a course in human anatomy, physiology, and pathophysiology to include the effects of anesthesia on the cell, the circulatory system and the respiratory system. NGR6422 Prin of Anesth Nursing II This will emphasize the anesthetic management of pediatric, geriatric, and obstetrical patients. The specific anesthetic needs for each specialty. NGR6461 Pharm Anes Nsg II This course covers the uptake, distribution, and biotransformation of anesthetics, including the advanced study of therapy in anesthesia specialty and treatment complications. NGR6401 Chem and Phy Anes Nsg-II This course is a continuation of the focus on the biochemical and physical principles required for understanding the mechanisms, actions, equipment, and theories as they apply to anesthesia practice. NGR7768 Role Devel in ANP This course includes topics concerning further development of the role of the advanced practice nurse. Emphasis is on developing effective communication, and collaborative skills for the development and implementation of interprofessional teams, practice models, peer review, practice guidelines, health policy, standards of care, and/or scholarly endeavors. NGR6432L Anesth Nursing Practicum II This is the second in an increasingly more complex seven-course series that includes clinical anesthesia administration under the direct supervision of a CRNA and/or anesthesiology instructor. NGR6490 Regional Anesthesia This course covers theoretical and clinical aspects and management of regional anesthesia, Anatomy, physiology, and pharmacology will be studied and applied to the administration of anesthetic blocks. 18

19 Revised January 2015 NGR6423 Prin of Anesth Nursing III This course covers principles of cardiothoracic anesthesia, preoperative assessment, pre, intra, and postoperative management, extracorporeal circulation, cardiac assist devices, and pharmacological intervention. NGR7850 Evidence Based Practice I In this course students use analytic methods to critically appraise existing literature and other evidence to determine and implement the best evidence for practice. The student will begin to apply relevant findings to develop and analyze clinical practice guidelines and improve practice and the practice environment. NGR6433L Anesth Nursing Practicum III This is the third course in an increasingly more complex seven-course series that includes clinical anesthesia administration under the direct supervision of a CRNA and/or anesthesiology instructor. NGR7851 Evidence Based Practice II This course is a continuation of EBP-I in which students develop and test methods to measure outcomes and develop benchmarks. The main outcome of the course is the design of primary research to address factors within the healthcare system and/or the individual that are associated with evidencebased clinical practice guidelines and quality improvement processes. NGR6405 Adv Biosc Anesth Nursing II This is a course in human anatomy, physiology, and pathophysiology to include the effects of endocrine, neurological, orthopedic and excretory and digestive systems on anesthesia management. NGR6434L Anesth Nursing Practicum IV This is the fourth course in an increasingly more complex seven-course series that includes clinical anesthesia administration under the direct supervision of a CRNA and/or anesthesiology instructor. NGR6424 Prin of Anes Nsg IV This course covers principles of emergency and trauma management, as well as anesthesia specialty procedures related to orthopedics and neurosurgery.ngr6494 Adv Mod Pain Mgt ` This course correlates aspects of human anatomy, physiology, pathophysiology, and pharmacology as they relate to the diagnosis and treatment of acute and chronic pain. Pain assessment and multimodal pain management strategies are included. NGR6435L Anesth Nursing Practicum V This is the fifth course in an increasingly more complex seven-course series that includes clinical anesthesia administration under the direct supervision of a CRNA and/or anesthesiology instructor. NGR7974 Doctoral Project In this course the doctoral student will identify, with advisor approval, a problem or question that requires a change in health care or educational services, clinical practices, and/or policies that might be addressed in a particular leadership role. This problem should have relevance to current and emerging health care or educational issues. The result of the project will be a scholarly work, written at a doctoral level of complexity, dealing with the results of the evidence based analysis of the service, practice, or policy examined. NGR6894 Global Health Care and Culture In this course concepts associated with cultural diversity related to matters of health and illness are considered. Examples of variations both within and outside of the western viewpoint are examined. NGR7946 Residency in ANP This is clinically based practicum course. Doctoral students construct a learning contract that 19

20 Revised January 2015 details the acquisition of new or higher level clinical skills for which they were not fully prepared at a previous level. Student clinical experiences build in complexity and independence from previous practicum courses. NGR6491 Adv Anes Nsg Sem This course is an advanced clinical review as presented by the graduate students regarding specific case presentations. F. For degree programs in the science and technology disciplines, discuss how industrydriven competencies were identified and incorporated into the curriculum and indicate whether any industry advisory council exists to provide input for curriculum development and student assessment. The proposed program is not in the science and technology disciplines. G. For all programs, list the specialized accreditation agencies and learned societies that would be concerned with the proposed program. Will the university seek accreditation for the program if it is available? If not, why? Provide a brief timeline for seeking accreditation, if appropriate. The USDoE recognized accrediting agency for nurse anesthesia education is the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Application was made by UNF for accreditation of the DNP Nurse Anesthetist concentration. After reviewing the submitted documentation, on June 23, 2014 UNF was informed that the COA has granted accreditation to the program. In addition, the School of Nursing just had a re-accreditation visit for the Doctor of Nursing Practice program by the Commission on Collegiate Nursing Education (CCNE) and although a formal report has not been issue it is expected to state that the program meets all standards for accreditation and had no compliance concerns. No further reports will need to be submitted to either COA nor CCNE once final approval to offer the program as a stand-alone major as the curriculum will not undergo any additional changes. Therefore, if this proposal is approved, accreditation by both bodies would still stand. H. For doctoral programs, list the accreditation agencies and learned societies that would be concerned with corresponding bachelor s or master s programs associated with the proposed program. Are the programs accredited? If not, why? The Commission on Collegiate Nursing Education (CCNE) is the USDoE recognized accrediting agency for nursing education. The UNF School of Nursing is fully accredited by CCNE to grant the BSN, MSN and DNP degrees in nursing. The Council on Accreditation of Nurse Anesthesia Educational Programs, the USDoE recognized accrediting agency for nurse anesthesia education has accredited UNF to operate the DNP-NAP program to prepare graduates for entry into practice as nurse anesthetists. I. Briefly describe the anticipated delivery system for the proposed program (e.g., traditional delivery on main campus; traditional delivery at branch campuses or centers; or nontraditional delivery such as distance or distributed learning, self-paced instruction, or external degree programs). If the proposed delivery system will require specialized services or greater than normal financial support, include projected costs in Table 2 in Appendix A. Provide a narrative describing the feasibility of delivering the proposed program through collaboration with other universities, both public and private. Cite specific queries made of other institutions with respect to shared courses, distance/distributed learning technologies, and joint-use facilities for research or internships. The DNP will be delivered via a combination of distance learning (DL) and in-class presentation. The University currently charges an additional fee for DL courses to support distance learning and IT. All current faculty who teach in the DL program are expected to become certified in distance learning and all new faculty will be expected to be or become certified in DL instruction. In addition, the University has 20

21 Revised January 2015 two rooms equipped with video-tele conferencing equipment (VTC). These rooms are used to provide synchronous education to Tampa General and Halifax hospitals in order to minimize student s need to travel back and forth for classes. IX. Faculty Participation A. Use Table 4 in Appendix A to identify existing and anticipated full-time (not visiting or adjunct) faculty who will participate in the proposed program through Year 5. Include (a) faculty code associated with the source of funding for the position; (b) name; (c) highest degree held; (d) academic discipline or specialization; (e) contract status (tenure, tenureearning, or multi-year annual [MYA]); (f) contract length in months; and (g) percent of annual effort that will be directed toward the proposed program (instruction, advising, supervising internships and practica, and supervising thesis or dissertation hours). Please refer to Appendix A Table 4. All faculty currently teaching in the DNP Nurse Anesthetist concentration will continue to teach in the proposed program. B. Use Table 2 in Appendix A to display the costs and associated funding resources for existing and anticipated full-time faculty (as identified in Table 2 in Appendix A). Costs for visiting and adjunct faculty should be included in the category of Other Personnel Services (OPS). Provide a narrative summarizing projected costs and funding sources. Faculty currently funded from E & G funds will continue to be funded by these sources. The doctoral program already admitted the first cohort of students in January These students will remain in the program for three entire years, until December All funds from prior MSN-NAP program have been reallocated to current DNP-NAP program. Faculty salaries will remain the same, as well as the salary for A & P staff. It is a known fact that Anesthesia faculty are paid higher salaries than other faculty in the School of Nursing. This clear designation of the program as a major will allow for the establishment of a differentiated graduate-level tuition and therefore, development of an operating budget for the program. The proposed amount was derived by combining the tuition and all possible associated fees for the program. Some of these associated fees include travel to off-site locations (Tampa and General and Halifax Hospital) in order to have a faculty perform fist hand evaluations of students. One unique aspect of the program is the global health perspective. This is accomplished through the development of partnerships with Paracelseus University in Austria and the University of Amsterdam. This global perspective allows for renowned educators from both institutions to come to UNF to lecture the students and to work collaboratively with students on their research projects. It also allows for students to understand healthcare in other regions in order to incorporate concepts into the care they are able to provide here in the US. Students will be required to pay additional fees in the form of an agency fee to cover direct expenses for the students. These fees are assessed per student and are being requested as an agency fee as these costs are dependent on the vendors. Please refer to Appendix F for a listing of items to be paid out of agency fees. This clear designation of the program will allow for the development of an operating budget for the program as currently fees have been used for operations. The table below demonstrates the proposed tuition and fees. Proposed Tuition and Fees per student Proposed tuition (differentiated) $48, $3200 $51, C. Provide in the appendices the abbreviated curriculum vitae (CV) for each existing faculty member (do not include information for visiting or adjunct faculty). 21

22 Revised January 2015 See appendix E for copies of abbreviated faculty curriculum vitaes for the program and a list of all presentations and publications for the past year. D. Provide evidence that the academic unit(s) associated with this new degree have been productive in teaching, research, and service. Such evidence may include trends over time for average course load, FTE productivity, student HC in major or service courses, degrees granted, external funding attracted, as well as qualitative indicators of excellence. All full-time faculty teach 75% and have 25% time designated for research and service. Many faculty are part-time and their teaching load is directly related to their contract rate. Faculty have all been active with assisting student publications and presentations and have been active on their scholarly work. This past year we had one faculty member who was the president of the Florida Association of Nurse Anesthetists (FANA). This year, three faculty members will have completed their doctoral degree and two faculty members are in-progress to completion of doctoral degree. A bibliographical listing of all publications and presentations for the past year is also included in Appendix E. Over the past 5 years, the NAP program has graduated 156 students all of which passed their certification exams and have secured jobs at rates ranging between $125,000-$150,000. The table below demonstrates the number of graduates over the past seven years. Number of graduates per year Year Number of Graduates X. Non-Faculty Resources A. Describe library resources currently available to implement and/or sustain the proposed program through Year 5. Provide the total number of volumes and serials available in this discipline and related fields. List major journals that are available to the university s students. Include a signed statement from the Library Director that this subsection and subsection B have been reviewed and approved. The Thomas G. Carpenter Library has increased electronic holdings. A system is in place for library staff to orient doctoral students to searching the extensive electronic holdings. Librarians participate in the DNP Boot Camp curriculum and provide a class on databases, reference/citation software, detailed search strategies, etc. The librarians recently worked with SON faculty to evaluate and acquire the Joanna Briggs Institute EBP Database, it is now available to graduate students and is posted on the Nursing Library Database page of the library. Additional services available to student are included on the library website under Services for Students, distant learners, faculty, and community. Library user education programs include orientations, class lectures, research appointments, open tours, and workshops. The school librarian worked with the DNP Program Director to develop a curriculum unique to the evidence based practice curriculum. The doctoral students can make individual appointment with members of the library staff to develop refined search strategies for their doctoral projects. Interlibrary loan, laptop check out, group study rooms, are some of the other services available to students on the library Student Services website. 22

23 Revised January 2015 Databases Supporting Programs in the Brooks College of Health, MASTER LIST ABI/INFORM Global (ProQuest) Offers business and financial information for researchers at all levels. Used for business articles on health services administration. Covers 1923 to present. AIDS & Cancer Research Abstracts (ProQuest) Provides bibliographic data from the worldwide scientific literature as related to AIDS, immunology, virology, and cancer genetics. Biotechnology & Bioengineering Abstracts (ProQuest) Provides bibliographic coverage of ground-breaking research, applications, regulatory developments, and new patents across all areas of biotechnology and bioengineering, including medical, pharmaceutical, agricultural, environmental and marine biology. Business Source Complete (EBSCOhost) This database includes peer-reviewed, business related journals. Included as part of the coverage offered by this database are indexing and abstracts for scholarly business journals, dating back as far as CCH Health & Human Resources Research Provides a wide variety of coverage in the areas of: Human Resources Management, Pension and Benefits, Safety and Health, Payroll, Labor and Employment Law, Workers' Compensation, unemployment insurance/social Security Health Care: Medicare and Medicaid, Healthcare Compliance, Home Health Care, Managed Care, Food, Drug and Cosmetics Law, Medical Devices. Updated daily CINAHL Plus with Full Text (EBSCOhost) Nursing & allied health database. Offers complete coverage of English-language nursing journals and publications from the National League for Nursing and the American Nurses' Association, CINAHL covers nursing, biomedicine, health sciences librarianship, alternative/complementary medicine, consumer health, and 17 allied health disciplines. Offers access to health care books, nursing dissertations, selected conference proceedings, standards of practice, educational software, audiovisuals, and book chapters. Cochrane Library (Wiley) Contains high-quality, independent evidence to inform healthcare decision-making. It includes reliable evidence from Cochrane and other systematic reviews, clinical trials, and more. Combined results of medical studies. Health & Wellness Resource Center (Gale) Topics in health and medicine, medications, and wellness. Includes encyclopedias, directories, medical dictionary, magazines, journals, and newspapers. History of Science, Technology and Medicine (FirstSearch) International bibliography for the history of science, technology, and medicine and its influence on culture from pre-history to the present. Journals articles, conference proceedings, books, book reviews, and dissertations from 1975 to the present. Comprises four bibliographies: the Isis Current Bibliography of the History of Science, the Current Bibliography in the History of Technology (Technology and Culture), the Bibliografia Italiana di Storia della Scienza, and the Wellcome Library for the History and Understanding of Medicine. Journal Citation Reports (Thomson Reuters) Service for evaluating and comparing journals using citation data drawn from over 11,000 scholarly and technical journals from more than 3,300 publishers in over 80 countries. JCR shows the most frequently cited journals in a field, the highest impact journals in a field, and the largest journals in a field. The main source for journal impact factors. 23

24 Revised January 2015 MEDLINE (FirstSearch, ProQuest and Web of Science) Citations from Index Medicus, Index to Dental Literature and International Nursing Index. Index to citations and abstracts from over 3,700 journals in the medical and dental literature. Provided by the National Institutes of Health and the National Medical Library. Years Available: 1950 current Nursing and Allied Health Collection (Gale). All aspects of the Nursing profession -- from direct patient care to health care administration -- are covered in this collection. Including nearly 400 titles, this collection's current and authoritative content will be of use to both professionals already working in the field as well as students pursuing a nursing-focused curriculum. Natural Medicines (formerly Natural Standard) High-quality, evidence-based information about complementary and alternative medicine including dietary supplements and integrative therapies. Natural Medicines also provides grades that reflect the level of available scientific data for or against the use of each therapy for a specific medical condition. Ovid Ebook Collection (Wolters Kluwer) Includes over 325 e-books in health and medicine. The books cover clinical medicine, emergency medicine, primary care, nursing education, nutrition, mental health nursing, management and administration, and more. Ovid Journals (Wolters Kluwer) Full text of over 100 journals in nursing, healthcare, and related health and medical subjects. Coverage dates vary. Taylor & Francis (Taylor & Francis) As one of the world s leading publishers of scholarly journals, books, ebooks, reference works, and databases, our content spans all areas of the humanities, social sciences, behavioral sciences, science, technology, and medicine. B. Describe additional library resources that are needed to implement and/or sustain the program through Year 5. Include projected costs of additional library resources in Table 3 in Appendix A. Please include the signature of the Library Director in Appendix B. No additional library resources are required for the proposed program. C. Describe classroom, teaching laboratory, research laboratory, office, and other types of space that are necessary and currently available to implement the proposed program through Year 5. Rooms 1028 and 1030 in building 39A (School of Nursing) are fully equipped for videoteleconferencing (VTC) and have been used to teach classes to and from distant clinical sites for students currently enrolled in the MSN and DNP-NAP program for Nurse Anesthetists. There is currently dedicated laboratory (bench and simulation) being used for the DNP-NAP program. D. Describe additional classroom, teaching laboratory, research laboratory, office, and other space needed to implement and/or maintain the proposed program through Year 5. Include any projected Instruction and Research (I&R) costs of additional space in Table 2 in Appendix A. Do not include costs for new construction because that information should be provided in response to X (E) below. Additional space is not expected to be needed as the program is currently in operation. E. If a new capital expenditure for instructional or research space is required, indicate where this item appears on the university's fixed capital outlay priority list. Table 2 in 24

25 Revised January 2015 Appendix A includes only Instruction and Research (I&R) costs. If non-i&r costs, such as indirect costs affecting libraries and student services, are expected to increase as a result of the program, describe and estimate those expenses in narrative form below. It is expected that high enrollment programs in particular would necessitate increased costs in non-i&r activities. No new capital expenditure is required. F. Describe specialized equipment that is currently available to implement the proposed program through Year 5. Focus primarily on instructional and research requirements. Current simulation, bench research, and instructional technology will continue to be used. G. Describe additional specialized equipment that will be needed to implement and/or sustain the proposed program through Year 5. Include projected costs of additional equipment in Table 2 in Appendix A. Additional equipment is not needed; however, usual replacement of equipment will be needed given wear and tear of the equipment. H. Describe any additional special categories of resources needed to implement the program through Year 5 (access to proprietary research facilities, specialized services, extended travel, etc.). Include projected costs of special resources in Table 2 in Appendix A. The program does have a cohort in Tampa and one in Daytona Beach, therefore, resources are being requested to provide for faculty travel to evaluate students at these satellite locations. In addition, the DNP-NAP program has a global perspective, elevating student s awareness to the practice of anesthesia and healthcare in other countries,. Funds have also been requested to facilitate bringing experts from their field in other countries to lecture to the students and facilitate student evidence-based projects. I. Describe fellowships, scholarships, and graduate assistantships to be allocated to the proposed program through Year 5. Include the projected costs in Table 2 in Appendix A. Traineeships may be available through the Federal Health Resources Services administration. Through the period of the first seven graduating classes the NAP was able to secure $ 141,467. Students are able to apply for a limited number of tuition waivers. J. Describe currently available sites for internship and practicum experiences, if appropriate to the program. Describe plans to seek additional sites in Years 1 through 5. Current clinical sites being utilized are: UF Health, Jacksonville Mayo Clinic, Jacksonville St. Vincent s Medical Center, Jacksonville U.S. Naval Hospital, NAS, Jacksonville Garcia Facial Surgery Institute, Neptune Beach Tampa General Hospital, Tampa Flagler Hospital, St. Augustine Halifax Medical Center, Daytona 25

26 Revised January 2015 APPENDIX B Please include the signature of the Equal Opportunity Officer and the Library Director. Signature of Equal Opportunity Officer Date Signature of Library Director Date This appendix was created to facilitate the collection of signatures in support of the proposal. Signatures in this section illustrate that the Equal Opportunity Officer has reviewed section II.E of the proposal and the Library Director has reviewed sections X.A and X.B. 26

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