Registered nurses have typically been underutilized as members of the primary care team. Leaders in health care have recognized that registered nurses have a unique set of skills that can enhance the effectiveness of the healthcare team. Registered nurses can provide delegated care for episodic and preventive care, chronic disease case management, care coordination, transitional care management, and other primary care functions. The aim of this project is to enhance the role of the primary care registered nurse in rural Kentucky by recruiting and training undergraduate nursing students to practice in community primary care teams. Additional aims are to increase access to care and address the healthcare needs of patients in rural and underserved communities with an emphasis on chronic disease prevention and control, including mental health and substance use conditions. To achieve the aims of this project, a primary care enrichment program was created to educate BSN students to assume leadership and practice roles in primary care. The University of Kentucky College of Nursing partnered with the University of Kentucky Center of Excellence in Rural Health, Appalachian Regional Healthcare and Southeast Area Health Education Center to assist with achieving the goals of the project.
The goals of the primary care enrichment program are to 1) enhance BSN students’ knowledge and clinical skills in primary care and 2) improve the screening and management of patients with chronic health problems, including screening for behavioral health and substance use conditions. Students apply and are selected for the program based on a GPA of 3.0 or above and an essay describing their interest practicing in primary care in rural and underserved areas. Students who are selected receive an annual stipend and are required to enroll in four 1-credit-hour online seminars over the course of the program. Students are also required to complete 240 clinical hours in a primary care clinic in a rural, underserved area in southeastern Kentucky.
Seminars topics include the social determinants of health; role of the registered nurse in primary care; primary, secondary, and tertiary prevention strategies; mental health and substance use screening; quality and safety; managing populations; tracking outcomes; evaluation; and billing and reimbursement. In the primary care clinical setting, students are precepted by registered nurses and advanced practice registered nurses. Outcomes achieved thus far, development of the primary care enrichment seminars, student clinical experiences, lessons learned, and future plans for the primary care enrichment program will be discussed.
This project is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under grant number UK1HP31708 Enhancing the Role of the Primary Care Registered Nurse in Rural Kentucky, $1,770,319. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the US Government.