Site selection is the most consequential early decision in a DNP project — and the most common source of project delays, scope revisions, and timeline crises. Students who secure the right site with the right data access and the right champions early complete their projects on time. Students who underestimate site logistics spend six months negotiating access agreements while their cohort moves ahead. This guide explains what makes a site feasible, how to evaluate options, and how to navigate the administrative processes that stand between you and your data.
What makes a site feasible for a DNP project
The five feasibility criteria
- Population access: the site must have sufficient volume of the population you are targeting. A DNP project on sepsis recognition requires a site with enough sepsis patients to generate meaningful pre/post data. A project on pediatric safe sleep requires a site that sees pregnant women or new parents. Before committing to a site, ask: how many patients fitting my inclusion criteria does this site see per month?
- Data access: you need access to the data that measures your outcome. This means either access to the EMR (through existing reporting functions or your IT department), access to aggregate quality data (infection control dashboard, patient satisfaction reports, audit databases), or permission to conduct your own data collection (staff surveys, direct observation). Who controls this data, and will they grant you access?
- Administrative support: the site's leadership (CNO, unit manager, quality department director, medical director) must support the project. A DNP project requires time from staff for education sessions, data collection, and potential workflow changes. Without explicit leadership support, staff compliance will be low and the project will fail regardless of how good the intervention is.
- A clinical champion: you need an identified person at the site — not your academic advisor — who will advocate for the project within the organization, help you navigate internal politics, remind staff about the project when you are not present, and troubleshoot implementation barriers. This is often the unit manager, a clinical nurse specialist, or a respected senior staff nurse.
- Timeline alignment: the site's existing projects, accreditation cycles, staff turnover, and leadership transitions must be compatible with your project timeline. Sites in the middle of a Joint Commission survey, a major EMR transition, or significant leadership turnover are high-risk environments for a new DNP project.
IRB vs. QI determination: what you must resolve before data collection
Every DNP project involving data about human beings — patients, staff, or community members — must be classified as either human subjects research (requiring IRB oversight) or quality improvement (not subject to the Common Rule). Getting this determination wrong has serious consequences: conducting research without IRB approval is a federal violation; submitting a QI project through full IRB review when it is unnecessary wastes months and may confuse your committee about your project's nature.
| Criterion | Human subjects research (needs IRB) | Quality improvement (no IRB required) |
|---|---|---|
| Intent | Generalizable knowledge — findings intended to contribute to scientific literature beyond this organization | Organizational improvement — findings intended to improve care at this specific site; not designed to be generalizable |
| Data type | Identifiable data collected from individual human subjects specifically for the study; recruitment of participants | Aggregate, de-identified organizational data; audit data already collected for operational purposes; aggregate EMR reports |
| Intervention | Involves an experimental intervention not part of standard care; randomly assigning patients or staff to conditions | Implementing or evaluating an evidence-based practice that is already supported by published guidelines; no experimental assignment |
| Who decides | Your university's IRB; your practice site's IRB (if different) | Your university's QI/IRB office (most universities provide a QI determination letter); your practice site's QI or compliance office |
The grey zone: when you are not sure
If your project involves administering a validated survey to individual staff members or patients (not just aggregate reporting), collecting any identifiable data, or conducting structured interviews, submit a QI determination request to your IRB office — do not assume it is exempt. Most IRB offices have a short determination form (1–2 pages) that produces a written determination letter within 1–2 weeks for QI projects. This letter protects you, your university, and your practice site. Some programs require this letter as a capstone appendix regardless of determination outcome.
Facility agreements: what you need and how to get them
Most practice sites require one or more formal agreements before a DNP student can collect data or implement a project. The type and complexity of required agreements varies by institution:
| Agreement type | When required | Who signs | Typical timeline |
|---|---|---|---|
| Affiliation agreement (also called clinical site agreement or practice partner agreement) | When the student is not already employed at the site; sometimes required even for employees in separate organizational units; your university may already have an agreement with major healthcare systems | University official (Dean, Provost, or Contracts office) + Healthcare organization official (CNO, Legal, VP of Nursing) | 2–8 weeks if your university already has a template; 3–6 months if negotiating from scratch. Ask your program coordinator whether an agreement already exists before approaching the site. |
| Data use agreement (DUA) | When you will access de-identified aggregate data from the organization's systems (quality reports, infection control data, EMR reports) | University Data Privacy officer + Healthcare organization Privacy/Compliance officer | 2–6 weeks; required by HIPAA for de-identified but still potentially sensitive datasets |
| Business associate agreement (BAA) | When you will access any individually identifiable protected health information (PHI) | University + Healthcare organization; may involve your academic advisor as well | 4–8 weeks; adds HIPAA compliance requirements to your project |
| Letter of support (LOS) | Required by most DNP programs as part of the project proposal — administrative evidence that the site approves the project | CNO, unit director, VP of Quality, or other organizational leader with authority over the relevant department | 1–2 weeks once you have a relationship with the site leader; often the first agreement to secure |
When your employer is your project site
The majority of DNP students complete their projects at their current employer. This is often the path of least resistance — you already have relationships, data access, and organizational knowledge. However, it introduces specific considerations:
- Power dynamics in data collection: if you are a manager collecting survey data from staff who report to you, staff may not feel free to respond honestly. Use an anonymous survey platform (REDCap, SurveyMonkey) and have a colleague — not yourself — distribute the survey. Disclose your role in the project consent/information statement.
- Separating your employer role from your student role: your employer is not funding your project, your university is. Project deliverables belong to you and your university first; your employer receives the implementation plan and findings as a partner, not a client. Clarify this early with both parties.
- Conflict of interest disclosure: most universities require a conflict of interest disclosure when you are conducting a project at your own employer, especially if your project could affect your own unit's performance metrics or your own job. Disclose this to your IRB/QI office and your committee chair.
- Your employer's legal team: even for QI projects at your own employer, your organization's legal and compliance teams may require you to complete an internal project review process. Find out what this requires before you start. Many health systems have a nursing research council or clinical quality council that reviews nursing QI projects before implementation — attend a meeting early rather than submitting for review at the last minute.
Stakeholder identification and the power-interest grid
Identifying your stakeholders before you approach the site prevents the most common DNP project failure mode: securing approval from one leader, starting implementation, and then being stopped by another leader whose approval you needed but did not get.
Power-interest grid for DNP project stakeholders
Map every person or group who will be affected by or can affect your project onto a 2×2 grid:
- High power, high interest (Manage closely): CNO, unit director, quality department director, your clinical champion. These people can make or break your project. Meet with them individually before you submit your proposal. Get explicit verbal commitment (and a letter of support) from each.
- High power, low interest (Keep satisfied): hospital CMO or medical director, risk management, compliance officer. They do not care about your project specifically but can block it if it creates risk. Keep them informed with brief updates. Proactively address any concern they might raise (HIPAA, patient safety, staff workload) before they raise it.
- Low power, high interest (Keep informed): bedside staff who will implement the intervention, patients who will experience it, unit educators. They cannot stop your project but are essential for implementation success. Engage them in the design (how could this protocol be adapted to work better on this unit?) and keep them updated throughout.
- Low power, low interest (Monitor): ancillary departments tangentially involved. Monitor for changes in interest — a low-power, low-interest stakeholder can quickly become high-interest if your intervention affects their workflow.
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Frequently asked questions
Site refusals are more common than students expect and less catastrophic than they feel. The most common reasons for refusal: the organization has a competing QI initiative on the same topic; the unit is understaffed and cannot absorb a new project; leadership has concerns about data security or liability; the organization does not have an affiliation agreement with your university and does not want to negotiate one. If refused, start with a direct conversation — "Can you help me understand what concerns are preventing approval?" Sometimes the concern is solvable (you can modify your data collection plan, limit the scope, or have your university contracts office fast-track an existing agreement template). If the refusal is final, move quickly to your backup site. You should always have two or three potential sites in mind before approaching your first choice.
Yes — and for some DNP projects, this is actually a stronger design. Secondary analysis of publicly available datasets (CDC NHANES, HCUP, CMS Medicare claims data, state hospital discharge databases, VA health data) is entirely feasible for DNP projects focusing on population health, policy analysis, or health disparities. These datasets require no facility agreement, no IRB review for most analyses (they are de-identified public data), and no site approval. The tradeoff is that you lose the implementation component — a project using public data is typically a policy analysis, needs assessment, or evidence synthesis rather than a practice change project. Check with your program: some programs require a practice partner regardless of data source; others accept secondary data analysis as a standalone DNP project product.