Date of Graduation

Fall 12-15-2017

Document Type

Restricted Project - USF access only

Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Executive Leader DNP

First Advisor

Dr. Lisa Cowan

Second Advisor

Dr. Keith Dawson


In today’s healthcare environment, managing the cost of labor continues to be a top priority as labor is the largest driver, by percentage, in budgetary expense. Healthcare leaders play a critical role in managing labor cost and can accomplish this while still providing efficient care. The business skills competency, particularly in financial management, has been identified as an essential core competency for healthcare leaders. It is becoming more crucial for leaders to have the essential set of financial management knowledge, skills, and abilities (KSA) when it comes to having the right staffing and the right type of resources, at the right time, to meet care requirements and budgeted productivity targets. The aim of this Doctor of Nursing (DNP) evidence-based change in practice project was to engage managers and directors (both nursing and non-nursing) in learning departmental budgets and to train them in creating and implementing a position control and staffing plan toolkit aligned with the budget in partnership with finance. This project was introduced into four Northern California healthcare organizations. The project was developed under the guidance of the American Organization of Nurse Executives (AONE) core competencies framework and Benner’s novice to expert skill acquisition theory. Leaders were initially surveyed to benchmark current understanding and practice, and were then trained in financial management. Specific position controls and staffing toolkits were developed for each department in conjunction with finance. The effectiveness of the project was assessed by the participant’s evaluation of the training and toolkit and by the implementation of the staffing plan and position control as a change in practice into their operations.

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