Using Education to Create a Pipeline for BSN Students into Primary Care Practice

Purpose: To develop a primary care nursing minor and concentration for BSN students to create sustainable solutions to address the primary care nursing workforce shortage in Indiana.

Growing challenges exist in health care related to the increasing needs of the American aging population requiring greater complexity of medical care. The changing healthcare environment dictate a workforce competently trained to address these health care issues. In primary care settings, the registered nurse’s scope of practice is limited such that these nurses are not working to the full capacity of their license (Macy Foundation, 2016). Also, noted is the lack of undergraduate nursing curricula that prepares for primary care practice (Wojnar & Whelan, 2017). Nursing educators face many logistical challenges for coordinating community-based clinical experiences.

Description: To prepare nurses for a career in primary health care, our nursing educational programs need an increased focus on care coordination, chronic disease management, transitional care nursing, and disease prevention, as well as mental health and substance use screening and treatment. A nursing curriculum gap analysis was completed based on the Scope and Standards of Practice for Professional Ambulatory Care Nursing (2017) to identify student learning needs. Gap analysis results identified learning needs in the areas of roles and professional standards for ambulatory care nursing, information technology and communication, and coordination of care and transition management.

In partnership with a local healthcare system, nursing faculty developed three nursing elective courses including didactic and 50 clinical hours per course. Students in the traditional BSN track that complete all three nursing electives along with select supporting social science courses are eligible for a minor in primary care nursing. Students in the RN-BSN track that complete all three nursing electives are eligible for a concentration in primary care nursing.

Evaluation/outcomes: Nine students were enrolled in the first primary care overview course. Seven clinical sites were secured in clinical rotations, and seven preceptors were trained. Standardized tools are being utilized to measure student perceptions of their curriculum and preceptors, including the self-efficacy and performance in self-management support instrument (Duprez et al., 2016). Students’ comments and course reflections will also be utilized for evaluation. Long-term evaluation will include employment rates for new graduates into primary care nursing positions.
References
1. AAACN. (2017). Scope & standards of practice for professional ambulatory care nursing. (9th ed.). Pitman, N.J: Author.
2. Duprez, V., VanHooft, S., Dwarswaard, J., VanStaa, A., VanHecke, A, & Starting, M. (2016). The development and psychometric validation of the self-efficacy and performance in self- management (SEPPS) instrument. Journal of Advanced Nursing, 72(6), 1381-1395. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.12918
3. Josiah Macy Jr. Foundation. (2016) Registered nurses: Partners in transforming care. Retrieved from: http://macyfoundation.org/publications/publication/conference-summary-registered-nurses-partners in transforming primary care
4. Wojnar, D. M. & Whelan, E. (2017). Preparing nursing students for enhanced roles in primary care: The current state of prelicensure and RN-to-BSN education. Nursing Outlook, 65, 222-232.