HRSA Study-Enhancing Nurse Roles in Community Health (ENRICH): Undergraduate and Workforce Training and Education in Primary Care

Background

The Case Western Reserve University Frances Payne Bolton School of Nursing (SON) is partnering with established community-based veteran’s affairs (VA) primary care providers to provide undergraduate nursing students and licensed registered nurses with the education and training experiences necessary to practice primary care at the full extent of their license.

The proposed project enhances an existing academic-clinical partnership between the SON and the VA Center of Outpatient Education (COE) program. The COE is an interprofessional academic patient centered medical home model that includes learners from graduate programs in medicine, nurse advanced practice nursing, psychology, pharmacy and social work who learn and deliver contemporary evidence-based primary care services. Enhancements to the existing COE program and SON BSN curriculum is creating a pathway to primary care for undergraduate nursing students and augments the primary care skills of practicing registered nurses (RN). Participating nursing students and staff RNs will learn evidence-based primary care best practices to address chronic health concerns prevalent in the community, including obesity, diabetes, hypertension, asthma, depression, and addiction. Broad ranging opportunities such as health promotion education and coaching, chronic disease management, population health management, care coordination, mental health integration, and telehealth are emphasized. Additionally, other VA primary care clinics (home-based primary care, geriatrics, women’s health) make available extensive inter-professional community based learning opportunities.

Measurable objectives will be the implementation strategies used and program’s impact on: knowledge, skill, and attitude of the student and RN staff in primary care; teamwork; and engagement in QI work. Long term outcomes to be measured are: RNs students who choose primary care positions after graduation; staff RN satisfaction and turnover rate; patient access to care; and, patient outcomes. A rigorous evaluation plan will ensure that process and outcomes are continually measured and data are used to make improvements to ensure programmatic improvement and sustainability.

We have a strong team of SON faculty and VA COE faculty and staff who have expertise in interprofessional team-based primary care education and practice. The SON and the VA COE team will contribute the content of an implementation kit that will be used to spread the initiative.

Goals

  1. Identify the implementation strategies to recruit and integrate the BSN students into the VA COE Interprofessional Academic PACT and community based clinics to enhance RN primary care competency.
     
  2. Describe the strategies to enhance staff RN competence in the expanded role of the RN in primary care to prepare RN preceptors to teach and role model working at the top of the RN license.
     
  3. Understand the mechanisms to improve and expand the teamwork and collaboration of the existing Cleveland VA clinic Patient Aligned Care Teams (PACT) to include all learners.
     
  4. List the steps to enhance the existing BSN curriculum, student competence and faculty competence on the expanded role of the RN in primary care at the Frances Payne Bolton School of Nursing.
VA Component
  • Integration of the RN learners into COE
     
  • Enhancing Nursing staff to work at top of their scope of practice
     
  • Create and test a model for spread (VA COEs and CBOCs)
School of Nursing Component
  • Curricular enhancements
     
  • Coordination of students during Senior Practicum/capstone project
  • Mary Dolansky, PhD, RN, FAAN, Principal Investigator
  • COE Director - Susanne Hahn, MSN, RN and Megan McNamara, MD
  • Rebecca Mitchell, DNP, MSN, APRN; Project Liaison 
  • Patricia Burant, EdD, MA; Project Manager
  • Shannon Wong,  CPNP, MSN, BSN, RN; Faculty Community Nursing
  • BSN Faculty
Core Team School of Nursing

Amy Bieda, PhD, APRN, PNP-BC, NNP-BC; BSN Program Director
Mary Quinn Griffin, PhD, RN, FAAN, ANEF; Evaluation
Carol Savrin, DNP, CPNP, FAANP, FNP; Implementation expert

Core Team Cleveland VA

Mamta Singh, MD, MS, FACP; National Director of the Centers of Excellence in Primary Care
Suzanne Hahn, MSN, RN;  Nurse Manager of the Cleveland Wade Park Primary Care Clinic

Support

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $2,187,305.00 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.