Development and Implementation of an Ambulatory Care Nursing Fellowship

Outcome: 80% of participants will be able to state two tactics used in an ambulatory care nursing fellowship.
Purpose: Traditional nursing education often focuses on preparing nurses to care for patients in the acute care setting as opposed to where the majority of healthcare delivery occurs (ambulatory care). This results in a knowledge/skills gap in newly employed ambulatory care nurses. This disparity between education and employment could impact quality of care and patient outcomes. Addressing this gap through an effective ambulatory care transition-to-practice program is vital to ensuring the highest level of care.
Description: The nursing fellowship for ambulatory care nursing is designed to prepare registered nurses (RNs) with specialized skills and knowledge to excel in the ambulatory care setting. This fellowship addresses the growing need for comprehensive, patient-centered care outside of the hospital environment, focusing on chronic disease management, preventive care, and the integration of advanced technologies such as telehealth; emphasizing collaboration, top of scope work, patient education, and advocacy; and equipping participants to meet the diverse needs of patients in outpatient settings.
Nurses are grouped into bimonthly cohorts comprised of new hires in ambulatory care practice within a large academic organization. Cohorts include monthly training sessions over six months including introduction to ambulatory care; RN-led visits focusing on chronic disease management, annual wellness visits, and advanced care planning; care coordination and transition management; medication administration and safety; clinical case studies; and documentation and informatics. Each session focuses on a different topic presented by subject matter experts via a webinar format and corresponding to preassigned chapters from the AAACN Core Curriculum provided to each participant. Opportunities for open dialogue and discussion as a means of shared learning are also emphasized. Each participant is assigned an experienced mentor for 1:1 support.
Graduates of the fellowship are expected to improve patient outcomes by enhancing the efficiency of care delivery and contributing to the development of innovative care models. The fellowship prepares nurses to assume leadership roles in ambulatory care settings, driving improvements in quality and patient outcomes.
Evaluation: From July 2023 through April 2024, 15 newly hired RNs participated in the fellowship program. The closing session also included an open forum for feedback related to the fellowship. There was consensus that the planned webinar format was not conducive to the demands of the clinic's needs and schedules. Of the eight evaluation respondents, seven reported they agree or strongly agree that they are confident that what they learned in the fellowship will be useful in their job and would recommend the fellowship to other nurses.