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Arizona

Grant Number: D11HP08318-01
Project Title: Nurse Education and Training in Stroke Management and Acute Reperfusion Therapy (NET SMART)
Applicant Organization: Arizona State University
Address: 500 N. 3rd St., Phoenix, AZ 85004
Project Director: Anne Wojner-Alexandrov
Phone: (602) 496-0926
Email: anne.wojner-alexandrov@asu.edu
Organization Website: http://nursing.asu.edu/
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This project grant will support the N urse E ducation and T raining in S troke M anagement and A cute R eperfusion T herapy (NET SMART) Acute Stroke Fellowship, a continuing education program aimed at preparing advanced practice nurses (APNs) or clinical leadership roles in the care of acute stroke patients. Stroke is the third leading cause of death in the U.S., effecting over 700,000 Americans each year, with another 300,000 experiencing transient ischemic attack, and consistently ranks in the top 5 emergent hospital admission diagnoses. A current shortage of neurologists to respond to stroke emergencies is considered a significant factor contributing to low tissue plasminogen activator (tPA) treatment rates in the U.S., which remain at approximately 3-4% despite drug approval for ischemic stroke in 1996. With demands for the development of Stroke Centers increasing, and consumer expectations for acute stroke treatment rising, acute care hospitals are aggressively pursuing use of APNs to support this shortage area. Continuing education programs capable of building APN knowledge and skills are currently lacking, and urgently necessary to promote entry, and/or transition, to acute stroke APN positions, to support improved WA treatment numbers and expansion of Stroke Centers in the U.S. The NET SMART program will make available an internet-based Acute Stroke Fellowship, supported by on-site clinical preceptorships at an eastern and western participating Comprehensive Stroke Center. APN participants in NET SMART will complete a total of 19 internet-based modules; each module may be completed at participants’ own pace, and will be complemented by clinical learning activities and post-tests. Once all modules are successfully completed, participants will progress to the on-site clinical preceptorship and validation session, during which time an interdisciplinary team of clinical experts will evaluate diagnostic, clinical decision making, and overall critical thinking skills. Upon satisfactory completion of the entire program (internet-based modules and clinical preceptorship), participants will receive a NET SMART Acute Stroke Fellowship Certificate from the Arizona State University College of Nursing and Healthcare Innovation. NET SMART is positioned to play an important role in reducing stroke disability and death, ultimately improving societal outcomes and reducing stroke burden among those individuals at high risk for this cardiovascular disease.

California

Grant Number: D11HP08389-01
Project Title: LV1V-RN BRIDGE
Applicant Organization: St. Francis Medical Center/St. Francis Career College
Address: 3630 East Imperial Highway, Lynwood CA 90262
Project Director: Alice D. Campbell, BSN, MPH, NP
Phone: 310-900-8058
Fax: 310-763-3987
Email: alicecampbell@dochs.org
Organization Website: www.stfrancismedicalcenter.org
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative:  The L VN-RN BRIDGE program addresses NEPR Purpose RI: Nursing Bridge Career Ladder Programs. We are requesting a preference factor because our project will substantially benefit underserved populations.

LVN-RNBRIDGE will transition SFCC Licensed Vocational Nurse (LVN) graduates into the Associate Degree in Nursing (ADN) program at East Los Angeles College (ELAC), building on an eight-year collaboration between the colleges. ELAC has a long-standing RN program, but no space to expand. Today, SFCC has 240 LVN students poised to respond to the nursing shortage, if only existing nurse education programs could accommodate them. LVN-RNBRIDGE will expand ELAC’s ADN capacity by one third, enrolling 144 students in RN courses (over three years) taught by ELAC faculty primarily on the SFCC campus.

NEEDS TO BE ADDRESSED: California ranks last in the nation in RNs per capita, while the State’s nurse education openings continue to decline. RN shortages are most extreme in the Los Angeles region. ELAC’s RN program, where most SFCC VN graduates seek to enroll for their RN, has no space to enlarge its RN cohorts. However, SFCC can expand into additional space in the large building in which the college is located, providing space for this new L VN-RJ’T BRIDGE project. By providing career advancement opportunities for LVNs from low-income minority communities in Southeast Los Angeles, LVN-RN BRIDGE will increase the number of RNs caring for underserved populations.

PROPOSED SERVICES: ELAC faculty will provide core nursing courses, primarily on the SFCC campus, to SFCC LVN graduates who have completed their general education and RN prerequisites. Students will benefit from both ELAC’s ADN expertise and SFCC’s Comprehensive Student Support Services (academic, financial, and personal support; emergency assistance; social service referrals). L VN-RN BRIDGE will graduate at least 63 RNs by the end of the project period, and 63 RNs within the following 18 months.

This unique collaboration will achieve an 85% retention rate, an 85% passing rate on NCLEX-RN exams, and a 90% employment rate.

POPULATION GROUPS TO BE SERVED: Most students will be low-income minorities (primarily Hispanics and African Americans). L VN-RN BRIDGE will provide them with career advancement in the nursing profession. All graduates will work for at least two years in underserved areas, providing excellent culturally competent health care to low-income, minority, underserved population groups in Southeast Los Angeles and elsewhere, reducing their health barriers and healthcare disparities.

SFCC/ELAC LVN-RN BRIDGE
Grant Number:  D11HP08320-01
Project Title: Academic Nursing Bridge Career Ladder Advancement Support System (CLASS-AB)
Applicant Organization: Riverside City College
Address: 4800 Magnolia Avenue, Riverside, CA 92506-1299
Project Director: Dr. Marie Colucci
Phone: (951) 222-8238
Fax: (951) 222-8745
Email: marie.colucci@rcc.edu
Organization Website: http://www.rcc.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Riverside City College (RCC) proposes a three year HRSA Continuation Grant to relieve the nursing shortage in the surrounding region of inland Southern California.  The project will address retention of nurses and will further develop four career ladder bridge programs using previously established grant infrastructure with six regional hospitals.  The community is experiencing a severe nursing shortage crisis, and the project will address the crisis with increased retention of nursing students through an academic bridge career ladder project that includes distance education in partnership with California State University, Fullerton.  The continuing CLASS Academic Bridge Project will increase enrollment in CNA to LVN by 36 students; LVN to ADN by 30-50 students; CNA to ADN by 36 students; and ADN to BSN by 25 students.  The project will serve 127-147 nursing students and graduates.  The CLASS-AB grant project will increase the workforce of graduating RNs (ADNs) by 102-122 and the workforce of ADN to BSN nurses by 25 BSN nurses for an increase of 127-147 additional graduate nurses in the community nursing workforce.  The project will increase the number of graduate RNs and BSNs to begin to fill the many open nursing positions in all health care arenas. The nursing students will learn key concepts of cultural competency across the curriculum.  The CLASS-AB project is a model for other community colleges in decreasing the nursing shortage by increasing the number of graduate nurses from their nursing programs.

Riverside City College’s School of Nursing student body reflects and serves the minority, low income, and underrepresented populations of the community.  RCC nursing programs are the largest producers of nurses in the inland region of Southern California, with high student passage rates on the national nursing exams.  RCC integrates Healthy People 2010 focus areas and objectives into nursing courses. 

During this grant period, a new RCC School of Nursing Building will be constructed and equipped to state-of-the-art specifications; the Riverside Community College District has made a commitment to maintain the grant-funded nursing instructor positions so the increased HRSA nursing student capacity can be maintained; and the California State University, Fullerton partnership has pledged ongoing continuity for the distance education ADN-BSN program. 

The project results will be evaluated with quantitative and qualitative methods to document the outcomes of the project.

Grant Number: D11HP00510-06
Project Title: Improving Health Equity for Children and Families
Applicant Organization: University of California, San Francisco (UCSF)
Address: Department of Family Health Care Nursing, 2 Koret Way, Box 0606, San Francisco, CA 94 143-0606
Project Director: Janice Humphreys, RN, PhD, PNP
Phone: (415) 476-4432
Fax: (415) 753-2161
Email: Janice.humphrey@nursing.ucsf.edu
Organization Website: UCSF School of Nursing - http://nurseweb.ucsf.edu/ or Valencia Health Services http://nurseweb.ucsf.edu/conf/vhs/
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Summary: The need for our proposed program is based upon results of Healthy People 2010 health indicator data collected during our initial HRSA project and specifically addresses the increased incidence of overweight/obesity and sedentary behavior among ethnically diverse and underserved children seen at Valencia Health Services (VHS), our nurse managed center (NMC).

The proposal addresses this need by providing a number of services. First, the proposal directly addresses health disparities by increasing access to care at an established and highly regarded nurse managed center, VHS. Our goal is to increase access to care for uninsured patients and to increase patient access to preventive and acute care services. Second, the proposed project offers an innovative, multidimensional program to reduce overweight and obesity via a tailored, culturally sensitive program that promotes physical activity in children and families. We plan to achieve this goal through translational research-based primary care lifestyle interventions and evidence-based best practices in the areas of nutrition, physical activity and behavioral/mental health. We will enhance VHS provider skills and confidence in health counseling, offering: (a) activity counselor-based physical activity and nutrition interventions; (b) behavioral intervention to enhance parenting skills; (c) case management that coordinates, individualizes, and supports services; and (d) community-based mentoring to support patient goals and facilitate success.

The proposed services build upon the existing infrastructure at VHS and on our accomplishments during the previous HRSA funding period. We will partner with insurers, hospitals, and community agencies to provide incentives and support for children and families adhering to health-promoting programs. Finally, we will increase the number of undergraduate and graduate health professions students exposed to an interdisciplinary health-promoting curriculum and to services for multicultural children and families at risk for overweight and inactivity.

Colorado

Grant Number: D11HP8388-01
Project Title: Colorado Consortium for Nursing Leadership Development
Applicant Organization: Colorado Center for Nursing Excellence
Address: 5290 East Yale Circle, Suite 102, Denver CO 80222
Project Director: Karren Kowalski, PhD, RN, FAAN
Phone: (303) 715-0343, ext 15
Fax: (303) 715-0347
Email: karren.kowalski@worldnet.att.net
Organization Website: www.coloradonursingcenter.org
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of the Colorado Consortium for Nursing Leadership Development is to provide frontline nurse leaders with skills necessary to effectively lead and manage care delivery within complex health care systems. ( HRSA Purpose P3: Providing Managed Care, Quality Improvement and Other Skills Needed to Practice in Existing Organized Health Care ). Project goals are to improve frontline leader and staff nurse retention and patient satisfaction through development of frontline leaders, including charge nurses, nurse managers and supervisors by means of educational and coaching interventions. 

The need for this project is supported with strong evidence that creating work environments for nurses that are most conducive to patient safety and quality of care requires knowledgeable and effective nursing leadership.  Nursing research has also identified leadership and the working relationship with a staff nurse’s immediate supervisor as one of the most important factors in staff nurse retention. This critical need for leadership capability holds true for all components of the continuum of care and can be especially acute for those with the fewest resources including remote rural providers, long term care and public health systems. At the same time there is little evidence of focused development of leadership competencies for first level nurse leaders including charge nurses who serve as the frontline in managing communication breakdowns, unmet patient needs and expectations, upset staff and families and abusive behaviors of other members of the care delivery team.

Objectives of this project include the delivery of training, skill building and coaching for frontline nurse leaders designed to enhance and support their ability to manage change, communicate effectively, deal with difficult personnel problems and create a culture which encourages the growth and learning of each staff nurse while assuring patient safety and satisfaction. Project activities include the assessment of current leadership and coaching competencies, delivery of leadership educational content for frontline leaders; the delivery of coaching and skill building competencies for selected coaches; and the tracking, reporting, analysis, evaluation and dissemination of outcomes.  Project engagement, effectiveness and sustainability will be assured through the efforts of a Project Planning Committee composed of influential senior nursing leaders from across the state

A total of 12 acute and long-term care sites within Colorado will participate throughout the project period. They include sites within federally designated low income and underserved regions. In addition county and public health nurses from counties adjacent to project facilities will participate.  The project will impact a minimum of 5000 patients per year and a minimum of 120 frontline managers and 120 coaches who in turn will impact the work environment of significant numbers of staff nurses, conservatively estimated at 1200 in the first year alone.

Florida

Grant Number: D11HP08321-01
Project Title: RN Critical Care Residency for Urban and Rural Hospitals
Applicant Organization: Florida Hospital
Address: 601 East Rollins Street, Orlando, FL 32803
Project Director: Debra M. Pusateri, MSN, RN
Phone: 407-303-1680
Fax: 407-303-7708
Email: debbie.pusateri@flhosp.org
Organization Website: www.flhosp.org
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Florida’s nursing shortage has been described as intractable. There is increasing concern that the current shortfall may soon reach unprecedented levels, as the state’s older adult population continues to both grow and gray, and a disproportionately large percentage of its RNs near retirement. There is also wide agreement that capacity constraints and a lack of resources are responsible for the gap between the supply and demand for RNs in Florida. The shortage is especially daunting in critical care units—highly technical environments serving the most vulnerable of patients where nurses must be equipped with advanced training and specialty skills.

Florida Hospital is a 1,817-bed tertiary acute care medical center with seven campuses in the tri-county Orlando area. It is the largest healthcare provider in Central Florida and serves more Medicare inpatients than any other U.S. hospital. In response to the state’s need for increased capacity for nurse education and training, Florida Hospital proposes to expand its current adult critical care residency program beyond traditional classroom boundaries through electronic distance learning technology, bringing new educational opportunities to at least 500 recent graduate, transfer, and re-entry nurses practicing in 17 urban and rural hospitals in the Adventist Health System (AHS) across Florida. The proposed project addresses Purpose E-2 of the Nurse Education, Practice and Retention Program by developing and implementing a residency program to encourage mentoring and the development of specialty practice in adult critical care.

Residents will complete 60 hours of didactic curriculum consisting of current course content that has been transformed into electronic distance learning modules based on American Association of Critical-Care Nurses (AACN) core curriculum and National League for Nursing (NLN) continuing education standards, The project will also create two new, formalized training modules to prepare 385 experienced RNs to function in preceptor and mentor roles; and provide residents with up to 16 weeks of clinical experience guided by a preceptor and followed by clinical mentoring. Unlike traditional classroom programs, the in-time nature of the courses will give all project participants the flexibility to start at any time during the year, expanding the capacity and accelerating the process for educating, training, and mentoring novice nurses.

Project objectives will address BHPr Goal 3 and Healthy People 2010 Objective 12-1: 1) Increase theoretical knowledge of residents in the adult critical care specialty; 2) Increase the ability of experienced RNs to function as preceptors and mentors; 3) Increase the skill and clinical competence of residents, to promote improvements in job performance and quality of care; and 4) Increase the confidence and job satisfaction of residents, to promote increased retention. By using national testing instruments such as the Basic Knowledge Assessment Test (BKAT) to measure project outcomes and applying the Academy of Medical-Surgical Nurses’ Nurses Nurturing Nurses mentoring program, the structured and standardized nature of this project should allow others to replicate project activities. The project will also open the door for future expansion to 22 additional ABS hospitals outside of Florida, enhancing its geographical reach and potential long-term benefits on the nursing workforce pipeline.

Georgia

Grant Number: D11HP08391-01
Project Title: Journey Towards Excellence II: Preceptor & Mentor Development
Applicant Organization: Grady Health System
Address: 80 Jesse Hill Jr. Drive, SE, Box 26062, Atlanta, Georgia 30303
Project Director: Linda G. Toomer, MSN, RN
Phone: 404-616-5805
Fax: (404) 616-9639
Email: ltoomer@gmh.edu
Organization Website: www.gradyhealthsystem.org
Project Period: 07/01/07 – 06/30/10

Abstract Narrative: Journey Towards Excellence II: Preceptor & Mentor Development Project is a competing continuation application, which focuses on the Nurse Education, Practice and Retention (NEPR) Education Priority Area, Purpose E-2: Developing and implementing internship and residency programs to encourage mentoring and the development of specialties.

Journey Toward Excellence: RN Residency Program was funded in 2003 when the diminishing RN workforce in Georgia had severely impacted the RN vacancy rate at Grady Health System (Grady) in Atlanta, Georgia.  At that time, Grady’s RN vacancy rate was 41% compared to the national average of 11% and state rate of 13.3%.  This equated to 347.3 vacant full time positions.  To further compound the problem, over 50% of the RN workforce was newly licensed.  This 24-month program targeted registered nurses with less than 12 months experience, reentering RNs, foreign nurses newly licensed in the USA, and RNs changing specialties.   Nurses selected for the program were provided a comprehensive mix of structured clinical and theoretical education above and beyond the basic 90-day orientation with a clinical preceptor.  The program was built on the premise that a planned residency program would influence job satisfaction, improve retention, positively influence patient outcomes, and contribute to the development of culturally responsive nurses. The first 3 months of the program focused on basic knowledge and skill development.  As the resident progressed through the first year, advanced clinical, leadership, and critical thinking skills in a multicultural health care environment were fostered.  During the second program year, participants branched into self- selected areas of specialty.  Throughout the program, residents were to be mentored. Significant program successes include a comprehensive curriculum, a diverse group of residents, and a program retention rate of 88%.  Program weaknesses were the lack of formally trained preceptors and the absence of a developed mentor infrastructure.  This successful program is currently self-sustaining and department-based. Funding sought in this application will not include activities necessary to maintain this program rather it will target the development of milestones not achieved. 

The proposed project will build upon the foundation of the original project goals: 1) Facilitate the transition of newly hired RNs into competent nurses who are confident and provide safe care to a diverse, multicultural, under-served patient population; 2) Increase the recruitment and retention of newly hired RNs practicing in a facility which serves the underserved population; 3) Impact patient outcomes by improving job performance and patient care delivery; 4) Impact the RN agency utilization and vacancy rates by retaining RNs in the workforce, and address project goals not achieved.

The key outcome, nurse retention, will be positively affected through the goals of the proposed program.  Specifically the proposed project will impact goal # 2 by:  a) increasing the number, training, and satisfaction of Preceptors; b) developing a mentor program; and c) increasing the diversity of our preceptor pool to mirror the RN Resident population.

Grant Number:  D11HP08357-01
Project Title: Gateway to Health:Eliminating Health Disparities in the Homeless
Applicant Organization: Nell Hodgson Woodruff School of Nursing at Emory University
Address: 1520 Clifton Road, Atlanta, Georgia, 30322
Project Director: Monica Donohue
Phone: 404-727-5291
Fax: 404-727-0536
Email: midonoh@emory.edu
Organization Website: http://www.nursing.emory.edu/nursing/index.cfm
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of this Nurse Education, Practice and Retention grant proposal, “Gateway to Health: Eliminating Health Disparities in the Homeless” which addresses NEPR Purpose P2, is to provide health care to a medically underserved, high-risk homeless client population at a large homeless services center known as the Gateway Center in downtown Atlanta, Georgia. The Nell Hodgson Woodruff School of Nursing (NHWSN) at Emory University will achieve this by expanding its partnership for health with the Gateway Center to include: 1) a faculty practice which utilizes the parish nurse model and focuses on health education, health counseling, health advocacy and referral, and the integration of faith and health for homeless clients 2) expanded and coordinated service-learning and clinical experiences for NHWSN pre-licensure RN students and graduate nursing students 3) utilization of a volunteer corps of nursing faculty, registered nurses, and nursing students with knowledge, expertise and/or interest in providing care to Gateway clients 4) project participation by an interdisciplinary team of students from the School of Nursing, Rollins School of Public Health and Candler School of Theology enrolled in the NHWSN Faith and Health Certificate Program 5) health education for the Gateway staff on health issues related to homeless ness and to the agency and 6)increased numbers of nurses skilled in the delivery of culturally competent care for the homeless.

The health care services provided through the faculty practice, with assistance from NHWSN students, an interdisciplinary team of students and registered nurse volunteers, will target the goal of eliminating health disparities as established by Healthy People 2010 and the Bureau of Health Professions. Services will spotlight Healthy People 2010 high priority Focus Area diseases prevalent in homeless populations and will include:

health education classes on disease prevention and health promotion, screenings for hypertension, diabetes and obesity, one-on-one health promotion counseling sessions, exercise classes, foot and hand clinics and healing services. Through advocacy and referral and the creation of a Health Resource Center within the Gateway Center, access to care will be improved. An integration of faith and health will also be reflected in this practice. During the three years of this project, 4,000 homeless clients will be served and 393 under- graduate and graduate nursing students will receive enhanced education.

“Gateway to Health: Eliminating Health Disparities in the Homeless” will strengthen the nursing workforce. By incorporating health care services that are reality based into the project, NHWSN will prepare a cadre of nurses who are comfortable in providing care to the underserved, encourage more nurses to move into careers that focus on meeting the needs of underserved populations and improve their retention. This project also seeks to increase the number of nurses skilled in the delivery of culturally appropriate health care for the homeless thereby improving the quality of care provided to vulnerable populations.

Grant Number: D11HP08387-01
Project Title: St. Mary’s Nurse Managed Health Center
Applicant Organization: Armstrong Atlantic State University
Address: 11935 Abercorn Street; Savannah, Georgia 31419
Project Director: Dr. Anita S. Nivens   
Phone: (912) 921-5724 
Fax: (912) 920-6570      
Email: nivensan@mail.armstrong.edu
Organization Website: http://www.armstrong.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: St. Mary’s Nurse Managed Health Center is a project submitted under Title VIII, NEPR Program to address Purpose P1:  Expansion of a nursing practice arrangement in a non-institutional setting to demonstrate methods to improve access to primary health care in medically underserved communities. This Project will expand primary care services to address the health needs of low income, uninsured and disadvantaged persons living in Chatham County, Georgia and represents a collaborative endeavor between Armstrong Atlantic State University (AASU) and St. Mary's Community Center. Both organizations are located in Savannah, Georgia. To date, an arrangement between AASU's Department of Nursing and St. Mary's Community Center has yielded the establishment of a small, part-time pilot nursing project staffed by volunteer NP faculty. The goal has been to provide limited primary healthcare to uninsured residents of the Cuyler-Brownsville neighborhood in Savannah. This project will expand the current St. Mary’s pilot into a fully operational nurse managed center that has the capacity to provide free primary care services to uninsured clients in Chatham County. The expansion will increase the geographic boundaries of the project to include the larger Chatham County area. This project is timely and needed in that the poverty level for Georgia residents is higher than the national average.  The State of Georgia also has the fastest growing number of uninsured individuals in the nation.  It is estimated that 15.8% of Chatham County residents in this region are uninsured with racial disparity noted in both the uninsured rates as well as the number of local residents with no primary care provider.

The St. Mary’s Nurse Managed Health Center project utilizes several HRSA goals as foundational to the project objectives that are explicated as follows:

1. Expand the existing St. Mary’s clinic pilot project to a nurse managed center with increased capacity to provide primary care for uninsured clients in Chatham County, Georgia (BHPr Goal 2: Eliminate Health Disparities: Assure the availability of a full range of healthcare skills and services to populations bearing a disproportionate share of disease and disability).
2. Acquire electronic technologies and information systems within the nurse managed center to facilitate communication and continuity in the provision of primary care.
3. Establish clinical education sites within the nurse managed center for nursing and other health professions students ( BHPr Goal 3: Assure Quality of Care: Improve the knowledge, skills, competencies and outcomes of the health professions workforce).
4. Network and share information and expertise with other nurse managed centers in the state and nation.

Illinois

Grant Number: D11HP08319-01
Project Title: Integrated Health Care Without Walls (IHC WOW)
Applicant Organization: University of Illinois at Chicago, College of Nursing
Address: 845 South Damen Avenue (MC 802) Chicago, IL 60612
Project Director: Judith Lloyd Storfjell, PhD, RN
Phone: 312-996-4299
Fax: 312-996-3848
Email: jstorfjl@uic.edu
Organization Website: www.uic.edu/nursing
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Integrated Health Care (IHC) is a nurse-managed center of the College of Nursing (CON), University of Illinois at Chicago ((MC) through which UIC faculty family nurse practitioners and mental health clinical nurse specialists, provide integrated primary physical and mental healthcare services for people with serious mental illness (SMI) such as schizophrenia, bipolar disorder, or major depression and with or at risk for co-morbid chronic physical disease in partnership with Thresholds, the leading interdisciplinary freestanding psychiatric rehabilitation agency with locations throughout metropolitan Chicago. In spite of the fact that IHC has grown to four clinic sites located in or near these psychiatric rehabilitation centers, services remain inaccessible for one group of Thresholds clients (called members)—those who are homebound and socially isolated by limitations due their serious mental and physical illnesses—many of whom live in group homes or geographically clustered housing units.

The purpose of this proposed project is to dramatically increase access to integrated health care services in order to improve health outcomes for these vulnerable, hard-to-reach Thresholds members through an innovative combination of outreach strategies to include: a) house calls, b) group visits, and c) telemonitoring—called IHC Without Walls (IHC WOW). We will broaden our award winning, evidence-based clinic model by linking these new components to our existing clinic services.

As an academic nursing practice, we view IHC WOW as an opportunity to integrate teaching and evidence-based practice; accordingly our objectives include expansion of novice and advanced practice experiential learning within this innovative practice domain. Specific project objectives include 1) increasing access to quality, cost-effective integrated primary and mental health care for a total of 450-500 hard-to-reach Thresholds members using house calls (decrease barriers to healthcare and health disparities); 2) delivering tailored interventions during group visits complemented by home telemonitoring to improve therapy adherence and clinical outcomes and 3) expanding nursing faculty knowledge and practice and structured pre-licensure and advanced practice nursing student experiential learning related to integrating mental and physical health care. We propose to make IHC WOW a delivery model that is distinctive, sustainable, and exceptionally cost-effective, as well as able to be replicated so as to build capacity for unparalleled health outcomes for a broader group than we now serve.

Indiana

Grant Number: D11HP08366-01
Project Title: Nursing Careers Advancement Continuation
Applicant Organization: Ivy Tech Community College Region 5
Address: 1815 East Morgan Street, Kokomo, IN  46901
Project Director: Laurie Peters          
Phone: 765-459-0561
Fax: 765-454-5111
Email: lpeters@ivytech.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The Nursing Careers Advancement Continuation (NCAC) program will address Purpose R1:  Grants for Career Ladders.  The NCAC program will assist those individuals who wish to become nurses or who are nurses and wish to advance their education and careers in several ways.  The program will set up cohort groups of students with similar goals and provide mentoring, advising, career guidance, and special classes to help them prepare for admission to appropriate academic programs and to succeed in those programs after they are admitted.  The program will also provide additional nursing faculty which will allow Ivy Tech State College Region 5 to significantly increase the number of students admitted to both the LPN and ASN programs and also the number of clinical sites available in the six county area served by the College.  The NCAC program will be marketed to the general public with special attention to attracting males, minorities, and disadvantaged groups into nursing career advancement.  These students will be assessed and directed to a program that is appropriate to their education and career levels.  They will form cohort groups of students who will work toward attaining nursing credentials including Certified Nursing Assistants, Licensed Practical Nurses, and Registered Nurses.  Bridge classes will help students in nursing who wish to proceed to the next level.  A project coordinator and a clerical staff person will be employed to assess, advise, mentor, and track these students.  Additional nursing faculty will be employed which will enable the College to grow the CNA, LPN, and ASN programs.  Increasing the number of training slots available and offering supplemental career and academic guidance to students and nurses will result in an outcome of more enrollment and program completion of nursing personnel.  These students will be more aware of pathways to further their education and careers.

This NCAC program will continue with the goals and student guidance that is already in practice from funding from a previous three year NEPR Career Ladder Program instituted in July of 2001 here at Ivy Tech Community College.  This first three year grant period had a heavy focus on CNA to LPN due to the fact that is was the beginning of the career ladder program. With the addition of this program the College has seen an increase in the number of students wanting to bridge from the LPN program to the ASN program as ASN transitional students.  The NCAC would allow us to accommodate those students that have completed the first two levels, CNA and LPN, of the career ladder and are pursuing the third level of ASN. 

Maryland

Grant Number:  D11HP08390-01
Project Title: Distance Learning Nursing Curriculum
Applicant Organization: The Community College of Baltimore County
Address: The Community College of Baltimore County, Catonsville Campus, 800 South Rolling Road, Baltimore, Maryland 21228-5317
Project Director: Roberta A. Raymond, Ph.D.
Phone: 410.285.9561 (Nancy Smith, Grants Office Director)
Fax: 410.285.9988
Email: nsmith4@ccbcmd.edu
Organization Website: www.ccbcmd.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative:  The Community College of Baltimore County (CCBC) plans to provide nursing students with an alternative method of instructional delivery for the Registered Nursing Program. The proposal is for a one-day a week hybrid nursing program with a didactic component that will be presented in an online mode utilizing CCBC’s nursing curriculum restructured for electronic access by participating students. The current CCBC nursing curriculum will be reconfigured from nine courses five and offered in this online delivery mode.

The one-day a week program will enroll 96 students who meet eligibility requirements of recent experience in direct patient care, completion of all general education requirements, and prerequisite courses for the admissions process for the online nursing program. The target population will include the nursing employees at three Baltimore City and County partner hospitals: St. Agnes Hospital, Franklin Square Hospital Center, and Union Memorial Hospital. The demographics of the employees of these hospitals indicate that their race and ethnicity are diverse, enabling the college to potentially reach a broader population.

The advantages of the hybrid program are:

• Students are able to learn the didactic material at a convenient time for them, with access to materials for instruction and review 24 hours per day, seven days per week. This will allow them to more easily accommodate their work schedules.
• The number of students who are seeking admission to the nursing program can be increased with minimal obstacles in obtaining the needed resources (i.e. nursing skills lab, clinical sites).
• The one-day a week program can easily be expanded to include students from a larger geographical area.

For the transition of nursing courses from the traditional to the online format, CCBC will work with SunGard Higher Education, a firm that provides software, strategic services, systems integration, and technology management services to help colleges and universities build, unify, and manage their digital campuses.

Grant Number: D11HP08393-01
Project Title: Baccalaureate Program Expansion
Applicant Organization: Coppin State University, Helene Fuld School of Nursing
Address: 2500 W. North Avenue, Baltimore, MD 21216  
Project Director: Dr. Marcella Copes, Dean  
Phone: 410-951-3990
Fax: 410-462-3032
Email: mcopes@coppin.edu
Organization Website: www.coppin.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of this project (E-1) is to expand Coppin State University’s Baccalaureate Nursing Program (CSU BSN) from 454 to 585 students over three years, a 29% increase. The project has the following objectives, which are consistent with BHPr National Goals 1, 2, 3 and the Healthy People 2010 goal of eliminating health disparities between minorities and non-minorities:

1. Expand the Generic Baccalaureate Nursing Program enrollment from 431 to 550, a 28% increase over three years, with 90% of students from under represented minorities.
2. Increase the number of Generic Baccalaureate graduates from 74 to 125, a 69% increase over three years, with 80% practicing in medically underserved areas. 
3. Expand the RN to BSN Program from 23 to 35 enrolled students, a 52% increase over three years, with 90% of students from under represented minorities,
4. Increase the number of RN to BSN graduates from 9 to 17, an 89% increase over three years, with 80% practicing in medically underserved areas.

The CSU BSN Program has more than twice the number of qualified applicants (350) than the program can now enroll. The 431 students currently enrolled in the traditional BSN Program represent a 91% increase in enrollment since 2003, when there were 225 students. CSU is an Historically Black College located in Baltimore in the high poverty inner city community of Coppin Heights/Rosemont. Our nursing students are prepared to deliver culturally sensitive health care to diverse populations within an urban environment. CSU graduates 80% of the baccalaureate prepared minority nurses in the State of Maryland and 80% of its graduates practice in Baltimore City.

The Helene Fuld School of Nursing is fully accredited by the National League for Nursing and fully approved by the Maryland State Board of Nursing. It has a proven success rate on the NCLEX examination over the past eight years with pass rates at or higher than the national average.  The CSU role in educating minority nurses takes on great relevance, since African Americans are underrepresented as Registered Nurses. Larger numbers of qualified minority baccalaureate prepared nurses will reduce health disparities between minorities and non-minorities in Baltimore City, where the incidence of sexually transmitted diseases, infant mortality/morbidity, HIV, substance abuse, hypertension & diabetes are the highest in the State.

This grant proposal qualifies for the statutory funding preference as provided in section 805 of the Public Health Service Act and represents a project that will “substantially benefit rural or underserved populations” as cited in CFDA 93-359. CSU has actively expanded undergraduate enrollment of the Helene Fuld School of Nursing, with prior BHPr seed funding, and has in each case sustained nursing faculty to accommodate the permanent increase in student nurse enrollment. Mid spring funding notification would assure full startup on July 1, 2007.

Massachusetts

Grant Number: D11HP08359-01
Project Title: RN Residency: Transitioning to Geriatric and Palliative Care
Applicant Organization: Massachusetts General Hospital
Address: 55 Fruit Street, Boston, MA
Project Director: Edward E. Coakley, RN, MSN, MA, MEd
Phone: 617-726-6152
Fax: 617-724-3497
Email: ecoakley1@partners.org
Organization Website: http://www.massgeneral.org/
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This proposal is in support of NEPR E2: Developing and implementing internship and residency programs to encourage mentoring and the development of specialties. There are 35 million adults in the US who are age 65 and older, comprising 12% of the current US population. In 2004, these older adults used 44% of all inpatient hospital days of care. The population of older adults is expected to double by 2030 in the face of a shrinking registered nurse (RN) workforce, increasing the demand for nurses who have specialized knowledge in the care of older adults with chronic conditions and end-of-life needs.

At the Massachusetts General Hospital (MGH), an ANCC Magnet hospital, we have identified a need to improve workforce capacity around the care of the older adult. The primary purpose of this project is to develop an RN residency program to meet the particular needs of older adults with chronic conditions and end-of-life requirements. Ninety employed RNs, at two experience levels, will transition into the specialty of geriatric palliative care using a mentorship model. A significant applicant pool of RNs employed at MGH is evidenced by 462 RNs with 2 to 5 years of experience and 650 RNs, age 45 and above.

A nine-month residency program will provide advanced education to 45 RNs (3 cohorts of 15 RNs), possessing two to five years of medical/surgical nursing experience, in the specialty of geriatric and palliative care. A four-month mentorship training program will enroll 45 RNs (3 cohorts of 15 RNs) age 45 and above, in a program that will prepare them with advanced education in geriatric and palliative care to serve as clinical preceptors for the younger nurse residents. Both programs will use nationally recognized curricula from The John A. Hartford Foundation’s program, Nurses Improving Care for Healthsystem Elders (NICHE), and the American Academy of Colleges of Nursing’s, End-of-Life Nursing Education Consortium (ELNEC).

Teaching methods will include classroom learning, interactive web dialogue with faculty and other clinical experts, and clinical practice. Clinical practice will occur across a continuum of care settings, e.g., hospice, rehabilitation, home and clinic, and acute care with geriatric and palliative care clinicians. The RNs, age 45 and above, imparting decades of embedded knowledge and wisdom, will mentor the residents in applying new learning in their practices.

The residency program will improve the retention of older nurses by providing opportunities for specialized training in the performance of this innovative role, designed to reduce physical workload while using decades of wisdom and newly acquired expertise. The residency program will likewise improve retention of nurses with two to five years of experience by providing opportunities for career development and mentorship. Therefore, the outcomes of the project will strengthen the nursing workforce in the specialty of geriatric palliative care to improve quality care for the elderly. Formative and summative evaluations will be conducted.

Michigan

Grant Number: D11HP00403-06
Project Title: Expansion of the McAuley Nurse Managed Health Center
Applicant Organization: University of Detroit Mercy McAuley School of Nursing
Address: 4001 W. McNichols Road, Detroit, Michigan 48221-3038
Project Director: Joyce Conley, PhD, RN
Phone: 313-993-1935
Fax: 313-993-1271
Email: conleyjo@udmercy.edu
Organization Website: http://www.udmercy.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This is a competing continuation application under the Nurse Education, Practice and Retention Program under Practice Priority P1.  Our purpose is to expand a Nurse Practice Arrangement in non-institutional setting (Nurse Managed Center) to demonstrate methods to improve access to primary health care in medically underserved communities.  The McAuley Nurse Managed Health Center (MNMHC) was established under a five year grant from the Health Resources and Services Administration ( grant #D11HP00403 for 7/01/02-6/30/07 ).  MNMHC is administered by the University of Detroit Mercy (UDM) McAuley School of Nursing.  The site is on the east side of Detroit, the most economically distressed and underserved area of Detroit where residents have great difficulty accessing primary care.  When the initial grant was written, Detroit was the poorest of the large cities in the U.S. and remains so today.  Unemployment has increased in recent years to 17.5%, with 280,000 uninsured and 390,000 on Medicaid.  Since opening in 2003, MNMHC has provided adult primary care and integrated mental health services to over 2200 clients and conducted multiple community outreach programs.  We are making a difference in the health and well being of our community. Services are available on a same-day or same-week basis, providing an alternative to hospital emergency center visits.  This grant application proposes to expand our adult services and begin to provide primary care services to children. In Detroit, the infant and child mortality rates, percentage of low birth weight rates, and the number of children living in poverty are among the highest in the nation’s fifty largest cities.  Although Michigan children below the poverty line have Medicaid insurance, many do not access these services. This grant also proposes that MNMHC further expand access by adding sites within the community and expanding hours of operation.  These efforts will expand access to care, expand faculty practice and student learning opportunities, and further provide for sustainability.  Our patients deserve the continuation of our services.  The changes we propose will lead us to self sufficiency. We also educate graduate and undergraduate nursing students at the MNMHC.  Through the expansion grant we will nearly double the number of students having a rotation at the Center. Over 70% of our graduates practice in the Detroit area after graduation, making a significant contribution to health care resources in the community. 

The objectives for MNMHC during this project period are to:

Objective #1 Expand a nurse practice arrangement (NPA) to provide increased access to primary health care and health promotion and disease prevention services for adults with a new expansion into primary care services for children in underserved communities (BHPr Goal #2 and Healthy People (HP) 2010 Goal #2).

#Objective #2 Establish long term financial sustainability through a professional business focus and the combination of revenue sources and operating expenses, including grants and other sources to fund all or part of non-profitable services (BHPr Goal #2 and HP 2010 Goal #2). 

Objective#3 Expand student clinical nursing experiences that emphasize leadership, cultural competence , community and interdisciplinary partnerships, population-based planning and the goals of Healthy People (HP) 2010 to undergraduate and graduate students (BHPr Goals 1&2, HP 2010).

Minnesota

Grant Number: D11HP08358-01
Project Title: Department of Nursing Expansion
Applicant Organization: Bemidji State University
Address: #27, 1500 Birchmont Drive NE, Bemidji, MN  56601
Project Director: Ranae Womack, Ph.D., RN
Phone: 218-755-4107   
Fax: 218-755-4107
Email: rwomack@bemidjistate.edu      
Organization Website: http://www.bemidjistate.edu/nursing/
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: As the U.S. Department of Health works toward assuring Congress that adequate numbers of nursing students are in the pipeline to address the anticipated workforce needs for the next decade, Bemidji State University offers an opportunity to count 100 new nursing graduates each year from northern Minnesota. 

The Goal of this proposed project is to increase the baccalaureate-educated nursing workforce in rural Minnesota.  We will do this by approaching two primary objectives:

1. Increasing access of nursing education for rural and American Indian students; and
2. Increasing the quality of nursing workforce by preparing baccalaureate nurses for practice in rural Minnesota, who are workforce ready with a strong emphasis on cultural competence—this will be the signature of the BSU Nursing program.

Key to achieving these objectives is the addition of a 4-year baccalaureate track to augment the current RN to BS Completion track.  With this dual-track program, BSU will meet the needs of both types of students—traditional 4 year students seeking a university experience; and current registered nurses in the workforce seeking to upgrade skills and pursue baccalaureate degrees.

BSU is making application under Purpose E1 “Expanding the enrollment in baccalaureate nursing programs” and will specifically address BHPr goal #1: “Eliminate Health Barriers: assure the appropriate supply, diversity, composition and distribution of the health professions workforce.”

Given that some states have placed a moratorium on new nursing education programs, Bemidji State University offers HRSA the opportunity to pursue its goal of educating more baccalaureate-prepared nurses –starting immediately in Minnesota.  This is especially needed because in 2004, every Minnesota public and private generic baccalaureate nursing program turned away qualified applicants, some as many as 60-75% of the applicants.

After much planning and preparation, the Minnesota Board of Nursing and the Minnesota State Colleges and Universities (MnSCU) system have encouraged and approved the expansion of Bemidji State University’s Nursing program.  What is needed now, is critical implementation funding to secure the director position for the 4-year track (which was funded for a one-year fixed term by MnSCU and to support the basic supplies and equipment necessary for the skills lab that is necessary for students entering the new 4-year track. 

We are acutely aware that, to be successful in growing our nursing program, we must be positioned to accommodate the shortage of nursing faculty, as well.  Our methodology will incorporate growing regional wealth through faculty recruitment efforts within our partner healthcare institutions as well as through the development of on-site clinical scholars that serve in both a practice setting as well as an educational setting.  Summer faculty institutes will support this approach…it’s a new paradigm in responding to the double-whammy faced by the nursing community—the shortage of nurses, and the shortage of faculty to educate more.  We are responding with innovative approaches to both.

Mississippi

Grant Number:  D11HP08360-01
Project Title: Expanding Enrollment in a Baccalaureate Nursing Program in South Mississippi
Applicant Organization: The University of Southern Mississippi, School of Nursing
Address: 118 College Drive #5095, Hattiesburg, MS 39406
Project Director: Kathleen R. Masters, DNS, RN
Phone: 601-266-5896
Fax: 601-266-5927
Email: Kathleen.Masters@usm.edu
Organization Website: http://www.usm.edu/nursing
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This program requests assistance under Title VIII, Section 831 of the Public Health Service Act, as amended by the Nurse Reinvestment Act of 2002; Public Law 107-205; 42 U.S.C. 296p for priority area El, Expanding Enrollment in Baccalaureate Nursing Programs. The purpose of the proposed project is to expand enrollment in order to subsequently increase the number of registered nurses available to meet the healthcare needs of populations in south Mississippi. The program addresses three of the HRSA Bureau of Health Professions’ goals: (1) Eliminate health barriers by assuring the appropriate supply, diversity, composition and distribution of the health professions workforce, (2) eliminate health disparities by assuring a full range of healthcare skills and services to populations bearing a disproportionate share of disease and disability, and (3) assuring quality of care through improving the knowledge, skills, competencies and outcomes of the health professions workforce. The specific purpose of this program will be to expand the enrollment in the baccalaureate nursing program at The University of Southern Mississippi (Southern Miss) School of Nursing (SoN) on both the Hattiesburg and Gulf Park campuses through the use of clinical simulation lab rotations.

The SoN at Southern Miss is in a position to address the issue of health barriers by impacting the supply of the nursing workforce. The SoN is one of seven baccalaureate programs in the state and graduates the largest number of BSN students in the state. The SoN has entry-level baccalaureate programs located in two locations in the southern part of the state: the Southern Miss Hattiesburg and Gulf Park campuses. Applicants for the nursing program reside in rural, underserved counties and usually remain in these counties to work after graduation.

The SoN is also in a position to address the issue of quality of care by improving the knowledge, skills, and competencies of the nursing workforce through the use of active learning strategies including clinical simulation to increase critical thinking skills, decision making, and knowledge application in baccalaureate nursing students.

Strategies to increase the supply of the nursing workforce and increase the quality of the nursing workforce will include the acceptance of increased numbers of students each semester by utilizing rotation schedules that incorporate clinical simulation experiences for each student during clinical courses by staffing the simulation labs with a faculty member.

Mississippi is a state historically plagued by poor health outcomes, with an inordinate number of residents living below the poverty rate and lacking access to quality health care. The state has been rated as the poorest state in the U.S. The incidence of diabetes, hypertension, hypercholesterolemia, and obesity is higher in Mississippi than in the rest of the United States, increasing the incidence of cardiovascular disease. Other factors that create access issues include the fact that most Mississippi residents live in rural communities with critical shortages of healthcare providers. Expanding enrollment in baccalaureate nursing programs and subsequently increasing the supply and quality of registered nurses will ultimately serve to eliminate health disparities by improving the health outcomes of populations in the rural communities in south Mississippi.

Missouri

Grant Number:  D11HP08365-01
Project Title: MU Leadership Development Academy for Registered Nurses in Long Term Care
Applicant Organization: The Curators of the University of Missouri
Address: S266 Sinclair School of Nursing
Project Director: Shirley Farrah, PhD, RN-BC
Phone: 573.882.0215
Fax: 573.884.4544
Email: Farrahs@missouri.edu
Organization Website: http://nursingoutreach.missouri.edu/
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative:  Nursing leadership is a key element in high vs. low-performing nursing homes. Directors of Nursing (DONs) are a critical link between working conditions and performance in Long-Term Care (LTC). They can create a climate that influences a facility’s organizational capacity to create and sustain improvement through their expert leadership. This results in improved staff performance, increased staff retention at all levels, higher quality of care to residents, better resident outcomes, improved risk management, and a better bottom line for the facility.

Yet, most RNs in LTC have not had the benefit of a structured educational program with a strong leadership focus to prepare them to manage effectively in today’s complex nursing home environment. Many experts agree that the high turnover of DONs in LTC is a direct result of the gap between the expectations placed on the DONs and their ability to meet those expectations. Nationally, the DON turnover rate is 49.7%; for Missouri it is even higher, 60.8% (AHCA, 2002). Most DONs hold a diploma or associate’s degree (where formal leadership courses are seldom a part of the curriculum), are from acute-care settings that differ sharply from LTC, are promoted to their DON position due to strong clinical skills rather than managerial competencies, and practice without a strong colleague reference group. The critical nature of nursing home leadership requires a change in this situation.

The purpose is to prepare a cadre of nurse-leaders in LTC who can create and sustain improvement in their work settings, including ability to emphasize staff involvement, facilitate communication and teamwork, set clear expectations and ensure high standards of care. To do this we will develop, implement and evaluate the MU Leadership Development Academy for Registered Nurses in Long-Term Care. The Academy’s innovative and evidence-based curriculum views nursing homes as complex adaptive systems where management practices, relationships, and climate are powerful determinants of turnover and resident outcomes. The nurse-leader’s impact on nursing home quality, and the facility’s capacity to create and sustain improvement, including a culture of safety, are imbedded throughout.

A multi-method approach to teaching and learning will be used, including two face-to-face workshops and six full-day classes at regional interactive television sites, to take place over eight months. An optional LTC Nurse Administrator certification review option will be offered. An electronic discussion board, e-mail, and online learning resources will facilitate ongoing contact with peers and faculty between the monthly classes, as will the LTC Mentoring Program. Graduates of the Academy, an official Certificate Program through the University of Missouri, will receive CE credit. We believe the proposed Academy is an important step in developing and retaining better nurse-leaders in Missouri.

Nebraska

Grant Number: D11HP08312-01
Project Title: Reducing Disparities in Type 2 Diabetes Care through a Network of Nursing Centers
Applicant Organization: University of Nebraska Medical Center
Address: 985330 Nebraska Medical Center Omaha, NE 68198-5330
Project Director: Kathryn Fiandt APRN, DNS, FAANP
Phone: 402-559-5265
Fax: 402-559-6379
Email: kfiandt@unmc.edu
Organization Website: www.unmc.edu/Nursing
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of this project is to significantly expand health services offered by a statewide network of academic nursing centers through development and implementation of a new program of services focused on a single health problem (type 2 diabetes), a particular population of vulnerable people (uninsured minorities and people living in poverty), and a single framework of health care delivery (Chronic Care Model). Type 2 diabetes is pandemic in this country. Minorities and people living in poverty are unequally affected, related to the stress and powerlessness of their social status as well as to genetic predisposition. The problem is further compounded by the significant disparities in access and quality of care received by minorities and people living in poverty as well as rural populations. The aim of the project is to reduce type 2 diabetes-related health disparities in minorities and people living in poverty throughout Nebraska through the implementation of a comprehensive program of diabetes risk and disease management. The innovative program takes a patient-centered approach designed to address stress and powerlessness through the use of the Chronic Care Model with a particular emphasis on self-management support. Access and quality of care issues are further addressed through delivery of care by a statewide network of community based academic nursing centers providing health education, disease screening and primary health care based disease management services (primary, secondary, and tertiary prevention services) in a culturally competent manner. The network of community based academic nursing centers has a long history of providing health care services in community, home and clinic settings. A chronic care database is used to collect data to support practice (quality) improvement and program evaluation. in addition, translational research standards will be used to assure that data collected support expansion of the evidence base for best nursing practices related to diabetes care and the care of vulnerable people. Undergraduate and graduate nursing and other health professions students are involved in care delivery using a service teaming model.

STATED STATUTORY PREFERENCE: THE PROJECT SUBSTANTIALLY BENEFITS RURAL AND UNDERSERVED POPULATIONS

Nevada

Grant Number: D11HP08371-01
Project Title: One Year Residency Program for Graduate RN’s
Applicant Organization: Board of Regents, Nevada System of Higher Education
Address: 4505 Maryland Parkway, Las Vegas, NV 89154-1037
Project Director: Susan Kowalski, RN, PhD
Phone: (702) 895-3404
Fax: (702) 895-4807
Email: Susan.Kowalski@unlv.edu
Organization Website:
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Aligned with the second educational purpose of the NEPR Program (E2), the specific purpose of this residency program is to improve critical thinking skills and professional competencies of new RN graduates in medical/surgical and specialty areas of two Valley Health Care system hospitals in Las Vegas, NV. Co-sponsored by the University of Nevada, Las Vegas, the subsidiary purpose of this project is to improve retention rates of new RN’s from a baseline of 92% to 98% at these hospitals.

Transition into professional nursing practice requires a supportive network for the new graduate, and a structured learning environment which provides opportunity for new RN graduates to master clinical skills, improve time management, develop clinical judgment and manage an increased patient care load. Satisfaction levels of new graduates in their first nursing position contribute to higher retention rates, lower recruitment and orientation coasts due to less turnover, and ultimately better patient care.

The proposed residency program offers theoretical and clinical components to new graduate RN’s employed at Desert Springs Hospital Medical Center, and Valley Hospital Medical Center. The residency program builds upon the hospitals’ current orientation and preceptorship period. In order to improve transition to a competent professional role the new program extends over a one year period and includes: 12 months of mentorship with a Residency Coordinator, 3 months of preceptorship with an expert clinical RN followed by 9 months of sponsorship with the previously assigned preceptor, monthly educational sessions and monthly peer support meetings. Evaluation occurs throughout the program and includes weekly evaluations between preceptors and participants, evaluations of stress/anxiety levels, evaluations of critical thinking and competencies, employee performance evaluations, and a final evaluation of the residency program. Clinical nurses serving as preceptors receive preparation and on-going education during the residency program to promote competency in their roles. The Residency Coordinators coordinate program activities and serve as valuable mentors.

The project strives to improve access to quality health care through appropriate preparation of the health profession workforce (National Goal I). The citizens of Nevada are an underserved population as evidenced by the second lowest ratio of nurses to population in the nation (520 nurses per 100,000). Nevada has the fastest population growth rate in the nation (increasing more than 66% between 1990-2000). Twelve percent of the population is over 65 years of age, and Nevadans engage in more high risk behaviors that contribute to poor health than any other state in the nation. This project contributes to producing and maintaining competent nurses for the ever expanding city of Las Vegas and the state of Nevada.

New Jersey

Grant Number: D11HP08369-01
Project Title: UMDNJ SN Wellness Mobile Healthcare Project
Applicant Organization: University of Medicine and Dentistry of New Jersey-School of Nursing (UMDNJ-SN)
Address: Stanley S. Bergen Building, Suite 1124, 65 Bergen Street, Newark, New Jersey 07107-3001
Project Director: Gloria J. McNeal, PhD, APRN, BC, FAAN           
Phone: 973-972-9814
Fax: 973-972-7853
Email: mcnealgl@umdnj.edu
Organization Website: http://sn.umdnj.edu
Project Period: July 1, 2007-June 30, 2012

Abstract Narrative: The objectives of this project are designed to address the Practice Priority Area P1: to establish nursing practice agreements in non-institutional settings to demonstrate methods to improve access to primary health care in medically underserved communities. The University of Medicine and Dentistry of New Jersey School of Nursing (UMDNJ-SN), in a collaborative, joint partnership venture, will implement a nurse-faculty managed Wellness Mobile Healthcare (SN-WMH) Project, designed to reduce the morbidity and mortality of medically underserved residents of the greater Newark area. As academic health science centers re-evaluate their goals and objectives to address the needs of their surrounding communities, university-based nursing programs are strategically positioned within such centers to take the lead. This proposal describes the collaborative approach and outcomes oriented focus of a nurse-faculty managed, university-based mobile health project, in partnership with the UMDNJ University Hospital, that will cost effectively utilize faculty-supervised student nurses and mobile health team staff, in association with the clinical affiliates of UMDNJ, community-based organizations, and faith-based healthcare initiatives. Situated within the UMDNJ-SN Stanley S. Bergen Jr. Center for the Study of Urban Health Systems, this initiative will uniquely create public-private partnerships, in the mutual goal to improve access to care for urban at-risk populations.

The broad objectives of this nurse-faculty managed SN-WMH Project are: 1) to establish a non-institutional nursing practice arrangement to improve access to primary health care in medically underserved areas; 2) to increase the diversity of the nursing health professional workforce by improving retention and graduation rates of the minority students enrolled in the undergraduate accelerated second degree BSN program and the graduate nursing specialty program; 3) to improve the quality of care by preparing professional nurses who can provide culturally competent and sensitive care; and 4) to increase the effectiveness of educational and community-based programs by fostering community involvement in the health education, assessment, outcome reporting, and referral process. Faculty and students will participate in workshops designed to increase their level of cultural competence. The success of the project will be evaluated using a variety of measures that track increases in the number of client encounters and referrals made by medically underserved patients, number of community partnership agreements established, number of educational materials translated in the languages of the communities served, and the retention and graduation rates of minority nursing students. Additionally, data will be collected to measure the degree of patient and staff satisfaction, level of change in county mortality and morbidity rates, and extent of faculty and student participation in the SN-WMH Project.

New York

Grant Number:  D11HP05200-03
Project Title: Long-Term Care Leadership Institute – Foundation for Quality Care
Applicant Organization: Foundation for Long Term Care, Inc.
Address: 33 Elk Street, Suite 300, Albany, New York 12207
Project Director: Edwin Graham
Phone: 518-462-4800
Fax: 518-426-4051 
Email: egraham@foundationforqualitycare.org  
Organization Website: www.foundationforqualitycare.org
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The Foundation for Quality Care, Inc. (FQC), located in Albany, New York, is a not-for-profit, 501(c) (3) education and research subsidiary of the New York State Health Facilities Association (NYSHFA).  The purpose of the Foundation for Quality Care is to provide educational opportunities to health care workers in long-term care facilities across New York State, and to conduct research in areas of quality care. One of the major initiatives of FQC is to provide career advancement training programs for nurses currently employed in long-term care facilities. To pursue this initiative, the applicant in partnership with the State University of New York- Institute of Technology- School of Nursing and Health Services proposes a Long-Term Care Leadership Institute, for the express purpose of promoting career advancement for nursing personnel (Retention Purpose R1 – Focus Area 1- Career Ladder Programs). FQC’s proposed training program is in alignment with the legislative funding preference because the Long-Term Care Leadership Institute will substantially benefit underserved populations (elderly and disabled residents of long-term care facilities).There is a critical need for the Long-Term Care Leadership Institute because of the significant shortages (vacancy rates) of registered nurses in front-line management and leadership positions in health care; high turnover of nurses in long-term care requiring strategies to improve retention; the dramatic increase in elderly residents in long-term care facilities and related staffing requirements to ensure quality care; the management skills gap experienced by nurses who are in leadership roles, or who aspire to be in senior level positions; the aging RN work force requiring training in current skills and career ladders; and the general need for greater diversity in the health professions, including the nurse leadership ranks.

The Long-Term Care Leadership Institute will consist of four distinct training programs Director of Nursing Leadership Program, Nurse Educator Leadership Program, First-Line Manager Leadership Program, and Facility Administrator Leadership Program with atotal of28 courses over three years, training 180 participants from 2006-2007, 180 in Year 2, and 200 in Year 3, for a total of 560 nurse participants. The curriculum and instruction, designed by FQC will consist of topics related to leadership skills, professional development, clinical skills, cultural competence, and career development. The training sessions will be offered in geographical areas throughout New York State that are easily accessible from a variety of long-term care facilities (Albany, New York City, Long Island, Syracuse, Utica, and Buffalo), and will draw from a diverse population pool of nursing staff from long-term care facilities across the state. The New York State Health Facilities Association will assist with recruitment. Participants who successfully complete the DON Leadership Program will receive three (3) elective credits and those completing the Nurse Educator Leadership Course will receive two (2) elective credits towards a Bachelor’s Degree, or in the case of the DON Program, a Master’s Degree through SUNY, Institute of Technology, School of Nursing and Health Systems. The FQC will also implement a mentorship component to the Director of Nursing training program and will publish an Employer Guide to Career Ladders for Nurses. The program will be evaluated by the Leadership Institute Advisory Committee, comprised of respected clinical, academic, and managerial long term health care professionals from across New York.

North Carolina

Grant Number: D11HP08313-01
Project Title: Professional Educational Achievement Recognition (PEAR) Program
Applicant Organization: Mission Healthcare Foundation, Inc.
Address: Mission Hospitals, 509 Biltmore Avenue, Asheville, NC 28801
Project Director: Brenda B. Harton, MSN, RN, Director, Clinical Support and Development
Contact: Bruce B. Thorsen, President and CEO, Mission Healthcare Foundation, Inc.
Address: 980 Hendersonville Road, Suite C, Asheville, NC 28803
Phone: (828) 213-1020
Fax: (828) 213-1030
Email: Bruce.Thorsen@msj.org
Organization Website: www.missionhospitals.org
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Mission Hospitals is proposing a nursing career ladder (consistent with NEPR Purpose R1) to increase the retention, skills, and satisfaction of the current, and future, nursing workforce, while increasing the quality of care and satisfaction of our patients. 

Mission Hospitals is the regional medical referral center for the western quarter of North Carolina and parts of several adjoining states. As the area’s “safety net” hospital, Mission provides nearly all medical and surgical services, including those that are greatly needed but are poorly paid by the government and insurers. The 21-county region of Western North Carolina served by Mission Hospitals is one of great diversity and need.  Many of the residents live in remote rural areas, with limited resources.  Dramatic increases in the aging, disabled, and minority populations and increases in chronic conditions are resulting in a demand to improve the quality of health care services provided.  Critical to the provision of quality healthcare is the retention of qualified, experienced nurses.  The aging workforce of the region, coupled with the increasing physical and psychological demands associated with providing care to the chronically ill and disabled, is resulting in a nursing crisis.  Although local colleges are producing diverse and qualified candidates, Mission must employ new methods to retain these graduates and increase the knowledge and skills of these professionals to better reflect the needs of our patients.

Based on the specific health care needs of the population, and the increasing demands on the nursing workforce, a career ladder is being proposed.  It will include continuing education, incentives and rewards, new roles for seasoned nurses, as well as research and networking opportunities.  The nursing staff will have the opportunity to become experts on the conditions associated with an aging and culturally diverse population.  Communication skills and cultural sensitivity will be major components of the program. By offering new opportunities for learning and advancement, the program is expected to not only increase the knowledge, confidence, satisfaction, and retention of the nursing staff but also increase the confidence in, and satisfaction with, the care provided by these nurses, as communicated by our patients.

Grant Number: D11HP08367-01
Project Title: Simulations and Partners Across Communities for Registered Nurse Education (SIM-PAC-RN)
Applicant Organization: Duke University
Address: Box 3322, Duke University School of Nursing, Durham, NC 27710
Project Director: Judith C. Hays, RN, PhD
Phone: (919) 684-9389
Fax: (919) 681-8899
Email: judith.hays@duke.edu
Organization Website: www.nursing.duke.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of this project as authorized in Title VIII PL. 107-205, Section 831 of the Public Health Service Act is to “expand enrollment in baccalaureate nursing programs (El).” Consistent with this purpose, this application seeks funds to expand and strengthen the current accelerated Bachelor of Science in Nursing (ABSN) program at Duke University School of Nursing (DUSON).

The number of practicing registered nurses was estimated as 1.89 million in 2000, against a demand for 2 million nurses. Nursing workforce projections for 2020 predict that demand for registered nurses may exceed supply by as much as 800,000, with shortages in 43 states (HRSA 2002), including NC and neighboring states. NC and the central Piedmont are medically underserved areas with excess prevalence of chronic health problems in a largely rural and minority population. Duke’s ABSN program has an applicant pool of qualified ethnically diverse individuals. Demand for spaces in each class is strong, but inadequate clinical sites and clinical instructors and under-utilization of patient simulation technology have limited admissions. To address this, we propose to build on partnerships and linkages in the Duke University Health System (DUHS) and regionally to expand infrastructure by increasing the number and diversity of clinical sites (Objective 1) and increasing the number and retention of clinical instructors (Objective 2). Then we will be able to enroll 6 additional students in each project year 02 and 03, for a 21% overall increase in annual cohorts (Objective 3). Additionally, we will partner across DUSON programs, DUHS and Duke University departments and Schools, and Research Triangle Institute to expand the patient simulation teaching capacity of our computer and clinical laboratories (Objective 4) in each of the project years. These objectives are in concert with HP2O1O and the BHPr goals. We have articulated an evaluation plan for each of the objectives. Our proposal will expand enrollment of entry-level nurses, train them in diverse sites with qualified clinical instructors using innovative patient care simulations, thus improving our ability to deploy additional registered nurses to address health disparities in our region. Our ABSN graduates are currently working in over 15 states in the nation. Thus, this project’s benefits extend beyond the North Carolina boundaries. This project will benefit rural and underserved populations; therefore, we request a statutory funding preference.

Ohio

Grant Number: D11HP08368-01
Project Title: Online RN Reentry
Applicant Organization: Sinclair Community College
Address: 444 West Third Street, Dayton, OH 45402-1460
Project Director: Marcia F. Miller
Phone: 937-512-2306
Fax: 937-512-2390
Email: marcia.miller@sinclair.edu
Organization Website: http://nursing.sinclair.edu/
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative:  The Nursing Department of Sinclair Community College (Dayton, Ohio) submits this proposal to address Retention Priority #1 creating a career ladder program to assist licensed, non-practicing RNs to reenter the work force to meet current and increasing staffing demands for nurses. Strategic partners include two of Dayton’s largest hospitals (Miami Valley Hospital and Good Samaritan Hospital), the Greater Dayton Area Hospital Association, Ohio Nurses Association, the Nursing Institute of West Central Ohio, numerous hospitals across the country that will serve as clinical practicum sites, and healthcare associations that will recruit nurses to participate.

Need: The significant healthcare need that will be addressed during this project is a major shortage of practicing RNs. The project will educate and return to the workforce non-practicing RNs in the following areas:

Year 1: in the greater Dayton, Ohio area

Year 2: in states with Appalachian designated counties

Year 3: nationally

Research indicates that the non-practicing, licensed RN represents a potential pool of individuals who have the skills needed by the healthcare system and can quickly reenter the workforce. Refresher courses offered through Web-based learning management systems have proven an effective medium for providing education to upgrade skills and knowledge – especially to RNs in less populated, geographically dispersed areas with limited access to educational opportunities.

Proposed Services : During the project 680 non-practicing RNs will be recruited and will complete a 37-hour online didactic core curriculum, have options for nine practice specific modules, and will complete an 80-hour competency-based practicum. The project will achieve self-sufficiency in the fourth year serving 600 RNs annually.

Sinclair faculty and staff have extensive experience offering online continuing education programs delivered on a customized Web-based learning management system. Three existing programs provide distance continuing education modules for over 8,000 paying allied health professionals annually, have secured 250 institutional accounts which pay for 24/7 access for employee continuing education across the country, and have registered nearly 22 million site visits from around the world.

Population to be Served: The primary audience is the RN (with a diploma, associate degree, or bachelor’s degree) who is not practicing in the clinical arena. Non-practicing RNs will be recruited from rural and underserved locations. A secondary audience is the currently employed registered nurse who requires continuing education for relicensure since all core modules provide 1.0 to 1.5 contact hours of continuing education.

Grant Number: D11HP08315-01
Project Title: BSN Career Ladders to Success for CNAs and LPNs
Applicant Organization: Lourdes College
Address: 6832 Convent Boulevard, Sylvania, Ohio 43560
Project Director: Kathleen L. Perzynski
Phone: (419) 824-3788
Fax: (419) 824-3513
Email: kperzyns@lourdes.edu
Organization Website: www.lourdes.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This project addresses Retention Priority Area Purpose R1: Career Ladder Programs which promote career advancement for registered nurses and nursing personnel. The purpose of this project is to impact the composition of the diversity and educational preparation of the nursing workforce in Northwest Ohio by increasing the number of students from underrepresented populations and increasing the cultural competence of baccalaureate prepared nurses. The continuation project plan focuses on the implementation of two career ladder programs including CNA to BSN and LPN to BSN with a major focus on the retention of students. The recruitment of students from racial/ethnic minority populations is emphasized. These programs are enhanced through the implementation of a new introductory course;  creation of a  “Learning Community” model; improving the mentorship program ( “Friends in Nursing” ); improving the cultural competence of faculty, graduates, and the curriculum; and expanding these programs to rural communities in Northwest Ohio.

Nursing education programs struggle to enroll student populations that reflect the composition of the communities in which they serve. The initial three years of this project demonstrate a dramatic increase of the student minority population for the nursing program from 13.5% in 2003 to 17.22% in Fall 2006. This improvement was a direct result of successfully enrolling CNA to BSN and LPN to BSN students with higher rates of diversity at 30.77% and 43.76% respectively. The project purpose aligns with the Healthy People 2010 objectives, the Bureau of Health Professions Goals, and priority plans by a number of organizations in the state of Ohio by increasing the proportion of underrepresented racial and ethnic groups in the health professions. The CNA to BSN bridge course includes role transition, self-directed learning skills, and an understanding of academic support systems to facilitate academic success. The LPN to BSN Fast Track includes an introductory course, a bridge course, with prior learning credits to be completed in 7 semesters. A LPN science bridge course is planned for Year 05. Continuation project strategies are designed to impact the high attrition rate (52%) of LPN to BSN students.

The continuation project includes three initiatives including an introductory course to professional nursing specifically designed for the LPN to BSN student, establishment of a “Learning Community” model for LPN to BSN students, and the creation of a Nursing Diversity Committee. The career ladder programs will enroll an additional 149 students including the expansion in rural communities over the next three (3) years and graduate nearly 35 students by project Year 06. Collaborative partnerships with two (2) community colleges and a major health care provider will facilitate access to these programs in rural counties of Northwest Ohio. An educational mobility consultant, a transcultural nursing consultant, and a socioeconomic diversity consultant will assist the project staff throughput the implementation. Statutory funding preference is requested for this project.

Oklahoma

Grant Number: D11HP08356-01
Project Title: “Educational Mobility for Oklahoma’s Rural Nurses”
Applicant Organization: Oklahoma City University, Kramer School of Nursing
Address: 2501 N. Blackwelder, Oklahoma City, OK 73106
Project Director: Marvel L. Williamson, PhD, RN
Phone: 405-208-5900
Fax: 405-208-5914
Email: mwilliamson@okcu.edu
Organization Website: www.okcu.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Professional isolation can lead to feelings of hopelessness for rural RNs wanting higher education to meet the needs of their communities and their own professional development goals.  Frustration is particularly intense for nurses who prefer or learn better in an environment with face-to-face interaction, because they have few or no options in rural areas.  RNs with associate degrees in nursing (ADN) must have better access to Bachelor of Science in Nursing (BSN) education to meet the higher qualifications needed for many nursing positions.  BSN education will also promote retention of nurses in the workforce by opening new opportunities for practice and expanding effectiveness.  As a rural state, Oklahoma averages 50.3 persons per square mile, compared to 79.6 nationally.  With only 694 RNs for every 100,000 people, it ranks 42 out of the 50 states in the proportion of RNs; only eight nationally have a greater need for more nurses.  Over 4,600 more RNs are needed today just to reach the national average (which is itself at a shortage level).  By 2010 Oklahoma will need 66% of its RNs to have BSNs, but only 36% will have that level of education.  According to recent data released by the Governor’s Council for Workforce and Economic Development, Oklahoma’s shortage of RNs is worsening in spite of efforts thus far.  The situation is compounded because Oklahoma is the only state with a rising death rate.  The health of its citizens is declining due in part to lack of access to adequate health care personnel, including RNs with BSN degrees.  Oklahoma City University proposes to provide its RN-to-BSN program to rural Oklahoma ADN nurses through both in-person and online courses with on-site technical support that build their competency with technology.  This project will provide the state with a larger resource of BSN nurses, as well as nurses eligible for graduate study to supply the state’s nursing schools desperate for qualified faculty.  The proposal targets the five rural regions of Oklahoma for a circuit of rural RN-to-BSN offerings.  Each year the program will start in a new rural region of Oklahoma in this order:  South Central (Chickasaw Country), Southeast (Choctaw Country), Northeast (Cherokee Country), North Central (Ponca Country), and Southwest (Comanche Country), with the last two starting after completion of the grant.  Each cohort of students will contain at least 15 students, but all applicants who qualify will be taken into the program.  By fusing both in-person and online education, the graduates will be better socialized, stronger oral communicators, and more comfortable with technology.

Grant Number: D11HP08356-01
Project Title: Expanding Basic Nursing Education in Rural Northeast Oklahoma
Applicant Organization: The University of Oklahoma –Tulsa College of Nursing
Address: 4502 E. 41^st Street, Tulsa, Oklahoma, 74135
Project Director: Geraldine Ellison, PhD, RN 
Phone: (918) 660-3978
Fax: (918) 660-3960
Email: geraldine-ellison@ouhsc.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of this continuing project is to further expand enrollment and graduation of rural students in the University of Oklahoma’s College of Nursing (OUCN) baccalaureate programs by offering BSN programs at two rural sites in Oklahoma through collaborations with rural hospitals and a community college. This project specifically addresses state and regional needs for a diverse and culturally competent nursing workforce, state health priorities, as well as the goals of Healthy People 2010, by increasing the BSN-prepared workforce prepared to provide culturally sensitive care within a health promotion, disease and injury prevention context. Specific project objectives are to (1) Increase access to quality healthcare for Oklahomans by offering  OUCN baccalaureate programs in two rural sites in Oklahoma (BHPr Goal 1 & 3); (2) Provide clinical training in community based nursing in which culturally sensitive care with a focus on health promotion and disease/accident prevention is provided in two rural and underserved areas of Oklahoma (BHPr Goals 1 & 3 and HP2010); and (3) Increase educational access and flexibility for rural students to continue their nursing education, while maintaining their residence in rural counties, through the use of a range of technology including e-learning, simulation, virtual simulation, informatics and video conferencing.

Oklahoma is a largely rural state with a significant number of medically underserved areas throughout the state. The two rural sites are located in far Northeast Oklahoma and Southwest Oklahoma and together will draw students from 15 rural counties. Three rural hospitals, technology centers, and a community college are collaborators in offering three program patterns leading to a BSN. The three program patterns that will be offered are the Career Mobility (CM) Program for LPNs and RNs (Sites 1 and 2); the Accelerated BSN (ABSN) program for Second Degree Students (Site 2) and the Collaborative BSN (CBSN) Program (Site 1).

The racial/ethnic profile of the rural sites is different from the rest of the state in that there is a higher percentage of minorities, primarily American Indians, than in the rest of the state. The 8 counties that comprise Site1 have a rate of 573 RNs per 100,000 population and 311 LPNs per 100,000. The 7 counties of Site 2 have 512 RNs and 516 LPNs per 100,000 in the workforce. The state rate is 694 RNs and the national is 825 per 100,000. Clearly, there is an inadequate cohort of BSN-prepared nurses in these areas and not unexpectedly there are significant health disparities and high incidences of preventable lifestyle diseases among the residents. Over the next three years this project will add a minimum of 68 BSN-prepared RNs to the workforce in these two sites.

South Carolina

Grant Number:  D11HP00503-06
Project Title: Expanded Primary Care Services to an Urban Area - Competitive Continuation
Applicant Organization: University of South Carolina, College of Nursing
Address: 1601 Greene Street, Columbia, SC 29208, USA
Project Director: Sara C. Fuller, PhD, APRN, CPNP, FAAN
Phone: 803-777-6533
Fax: 803-777-0550
Email: sara.fuller@gwm.sc.edu
Organization Website: http://www.sc.edu/nursing
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This Nurse Education, Practice and Retention (NEPR) Program grant is designed to meet purpose P1: establishing or expanding registered nursing practice arrangements in noninstitutional settings to demonstrate methods to improve access to primary health care in medically underserved communities. The project aims to improve access to primary and mental health care for an underserved population by expanding the community outreach of the Children and Family HealthCare Center (CFHC). It is an expansion of a currently funded grant to add mental health screening and services to the existing project. The CFHC is nurse-managed center, operated by the College of Nursing at the University of South Carolina. The CCFHC was established in 1998 to meet health care needs of vulnerable children being placed in protective custody because of actual or potential abuse or neglect. It is staffed by nurse practitioner faculty and provides primary care services to children in out-of-home placement and their caregivers, as well as the larger community. This project proposes to add one advanced practice clinical faculty member expert in mental health, continue the grant supported clinical coordinator/case manager and the indigenous community worker, expand the clinical placements of graduate and undergraduate students at the CFHC, and increase the practice involving selected faculty, undergraduates, and graduate students in community outreach activities. These activities will include follow-up services for existing clients and health screening, case finding, and community education. Additional staff members are required because of the expanded client contacts this project should generate and the mental health needs of the target population. Health screening and community education activities will focus on a series of interrelated mental health problems (depression/suicide prevention, prevention of substance abuse/cessation of tobacco, alcohol, and drug usage, and behavioral problems/prevention of violence and homicide), with a different emphasis each year.

Grant Number: D11HP08362-01
Project Title: Enhancing the Patient Care Delivery System: Creating Excellence through Synergistic Nurse/Patient Relationships
Applicant Organization: Sisters of Charity Providence Hospitals
Address: 2435 Forest Drive, Columbia, SC 29204
Project Director: Forrest Fortier, Director Organizational Development
Phone: (803)-256-5832
Fax: (803)-256-5469
Email: Forrest.Fortier@ProvidenceHospitals.com
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This project addresses the NEPR Retention Priority Purpose R2: Enhancing patient care delivery systems through improving the retention of registered nurses and enhancing patient care.  Creating synergy through “connecting the right people, with the right skills, in the right places, to achieve the right health outcomes” is the emphasis of the Bureau of Health Professions (BHPr) programs and the American Association of Critical Care Nurses Association (AACN) Synergy Model and is the framework for this project.  The proposed project supports the BHPr goals 1-4 and the National Healthy People 2010 goal to eliminate health disparities and focus area 12, Heart Disease and Stroke.  The three primary objectives of the project are to:

1. ENHANCE PATIENT CARE DELIVERY SYSTEMS by implementing the AACN Synergy model as a new patient care delivery model, to create synergy linking nurse competencies to patient needs for the best outcomes. 
2. PROMOTE CLINICAL EXCELLENCE THROUGH CULTURAL DIVERSITY by building a hospital community that values diversity in nursing staff, leadership, and patient populations, to assist diverse populations in overcoming barriers to healthcare and to develop a permanent system wide framework aimed at celebrating nursing’s growing diversity.
3. REBUILD A HEALTHY WORK ENVIRONMENT that provides autonomy and accountability for nursing practice and provides a supportive practice environment resulting in increased nurse retention and improve patient care.

A healthy work environment provides a cultural for nurses to act boldly and confidently to meets the needs of patients.  Health disparities can be better addressed through the diversification of nursing.  By increasing the nurse’s cultural diversity competencies, the nurse will be able to integrate cultural differences into patient care and be able to better respond and anticipate the patient and family needs resulting in synergy.  The synergy created will increase nurse involvement in decision making, improve the work environment, create a culture of learning, decrease work intensity and assure collaboration and communication among the interdisciplinary team.    The Synergy Model is a framework for designing nursing practice that reflects an integration of knowledge, skills and experience of the nurse.  It is through this framework, that Providence Hospitals will be able to connect the right nurses with the right competencies to meet the needs of the patients resulting in the right outcomes. The synergy created will cross the healthcare system resulting in enhanced patient care, increased RN retention, and reduced RN vacancy rates while improving patient satisfaction with the skill of the RN, decreasing falls, decreasing preventable codes, and increasing RN hours per patient day.

Grant Number: D11HP08361-01
Project Title: UpstateLateral Violence in Nursing Project
Applicant Organization: Upstate Area Health Education Center (AHEC), Inc.
Address: 14 Progress Road, Greenville, South Carolina 29607
Project Director: Candace A. Luciano, JD, MEd
Phone: 864-349-1160
Fax: 864-349-1179
Email: cluciano@upstateahec.org
Organization Website: www.upstateahec.org
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative:   Designed to meet NEPR Purpose P3, the primary goal of the Upstate Lateral Violence in Nursing Project is to provide registered nurses and senior nursing students, practicing or attending nursing school in one of the eleven counties of upstate South Carolina, with the knowledge and skills needed to recognize and effectively address lateral violence. By the end of the three-year grant period, more than 3,500 hospital and community health center nurses and senior nursing students will have participated in this project, reducing the incidents and harmful impact of lateral violence on nursing practice.

Lateral violence is often associated with oppressed peoples and situations involving unequal power relations. It has been defined as behavior consciously or unconsciously used to control, undermine, or devalue an individual or group. Examples of lateral violence in nursing include verbal abuse, intimidation, exclusion, unfair assignments, eye-rolling, denial of access to opportunities, and withholding of information. While generally ascribed to individuals, lateral violence is also symptomatic of unhealthy organizational dynamics; consequently effective interventions require support from nursing leadership as well as behavior changes in perpetrators and victims.

National and international studies, as well as informal surveys conducted with more than 200 upstate South Carolina nurses, indicate lateral violence is a pervasive problem within healthcare systems and schools of nursing. It has been linked to high nursing turnover, increased illness and absenteeism, decreased productivity, and lower quality of patient care; thereby adversely affecting the individual, the organization, and the patient. While virtually all nurses will, at some time during their career, experience lateral violence, newly licensed nurses are especially vulnerable to its detrimental effects.

This project addresses the problem of lateral violence in nursing at the organizational as well as the individual level and includes a range of targeted programs and services designed to reduce both its prevalence and harmful effects. Specific project components include: 1) Organizational Self-Surveys designed to assist nursing leaders in assessing their current institutional climate; 2) Nursing Leadership Summits held annually to provide a forum in which Chief Nursing Officers and nursing school Deans and Directors can explore best practices for addressing lateral violence; 3) Organizational Consulting to assist nursing leaders in planning, implementing, and evaluating lateral violence interventions within their institutions; 4) Skill Building Workshops tailored to meet the unique needs of five distinct groups: newly licensed nurses, staff nurses, nurse managers, senior nursing students, and nursing school faculty; and 5) Train-the-Trainer Classes designed to create a cadre of knowledgeable, school and organization-based instructors prepared to deliver the Skill Building Workshops both during and after the three-year grant.

Grant Number: D11HP08363-01
Project Title: Expanding the enrollment in baccalaureate nursing at SCSU
Applicant Organization: South Carolina State University Program of Nursing
Address: 300 College St, NE, Orangeburg, SC 29711
Project Director: Perdue, Bobbie J.
Phone: 803-536-8605
Fax: 803-516-4669
Email: bperdue@scsu.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of this proposed project is to increase the numbers of students from disadvantaged/minority backgrounds entering into and graduating from South Carolina State University (SCSU) baccalaureate nursing program. There are six objectives that have been formulated from the project. (1) Institute a “Comprehensive Academic Retention and Enhancement” (CARE) academic support program to prepare 170 vulnerable students from low wealth or minority backgrounds to be successful culturally competent, academically prepared baccalaureate graduated of SCSU.

(2) Expand the number of facial and ethnic students eligible for admissions to SCSU Program of Nursing through pipeline development activities in 4 low wealth rural counties (Allendale, Bamberg, Calhoun and Orangeburg).

(3) Increase the enrollment of students in the nursing program at SCSU by: a) increasing the number of freshpersons and sophomores who declare their intent to major in nursing from 241 to 350; b) Increasing the number of students admitted to upper division nursing from 54 to 100 in years 01, 02, and 03 or the project and beyond.

(4) Increase the retention rate of pre nursing and nursing major students from 20% to 70% during the life of the project and beyond.

(5) Modify the current nursing curriculum so that it prepares graduates who have the necessary skills, competencies and knowledge to reduce health disparities in South Carolina.

(6) Increase the cultural competence of faculty and students to better meet the educational needs of racially diverse students.

Once faculty member, retention specialist, counselor, office coordinator, 5 peer coaches and 5 peer tutors will partner with the Project Director, Co-Project Director and Nursing faculty to implement the program. There is a critical need for diversifying the nursing workforce in South Carolina. The proposal notes that many communities in South Carolina where SCSU is located are considered rural and underserved. There is widespread campus and community support for the program.

Tennessee

Grant Number: D11HP08355-01
Project Title: BSN Gateway RN-BSN Completion Program
Applicant Organization: University of Tennessee
Address: 615 McCallie Avenue, Dept. 1051, Chattanooga, TN   37403
Project Director: Dr. Kay Lindgren
Phone: (423) 425-4644     
Fax: (423) 425-4668
Email: Kay-Lindgren@utc.edu
Organization Website: www.tennessee.edu
Project Period: 07/01/07 – 06/30/10

Abstract Narrative: The University of Tennessee at Chattanooga (UTC) proposes to implement the BSN Gateway program in response to NEPR program purpose R-1 .  The BSN Gateway is an innovative program that will meet regional needs to recruit and prepare additional BSNs.  The program will recruit working RNs and implement a revised RN-BSN curriculum designed to provide a career ladder to the BSN while enabling RNs to remain at the bedside in regional health facilities.  To facilitate student learning, the curriculum has been re-packaged into five learning modules offered over a one-year period and delivered through a hybrid model system that incorporates distance education with traditional instructional strategies.  During the HRSA funding period, UTC will prepare three cohorts of RN-BSN students, 75 students total.

This program will enhance the nursing workforce in a 21-county region in southeast Tennessee and north Georgia, a region marked by severe nursing shortages, critically underserved urban and rural populations, and poor health outcomes.  By 2020 the nursing vacancy rate is projected to increase to 49% in Tennessee and 30% in Georgia. The BSN prepared nursing vacancy rate is projected to be even higher. Both Tennessee and Georgia face serious challenges to improving the health of residents and achieving HRSA’s Healthy People 2010 goals, ranking 48^th and 45^th, respectively, for poor health outcomes and indicators.  Because of the tremendous need, UTC has secured support from regional health care facilities and nurse executives, the Chattanooga Hospital Association, and community colleges.

The objectives are as follows:  (1) Increase enrollment in RN-BSN completion programs by enrolling and supporting 3 cohorts totaling 75 students during the project period; (2) Increase access to RN-BSN programs for working professionals by implementing a 24-credit hour hybrid (online / classroom) curricular model; (3) Decrease the time of BSN degree completion by providing an accelerated program that meets the needs of working RNs; (4) Increase BSN attainment by retaining 90% of program enrollees to degree completion within the project period. 

The program methodology includes traditional instruction as well as distance education strategies.  UTC has implemented a highly successful MSN Nurse Anesthetist distance education program and has a strong capacity to implement the distance education components of the BSN Gateway which include for each learning module; video streaming; use of Blackboard, a web-based instructional portal; and others.  Student support will include access to a dedicated IT Coordinator, Critical Friends groups and mentors, and program faculty and staff.  An Implementation Team will oversee all aspects of program implementation, and the program evaluation plan ensures that project staff and the Implementation Team will receive continuous feedback from participants and instructors.  UTC has a plan to achieve self-sufficiency for the BSN Gateway program upon completion of the HRSA funding period.  

Grant Number: D11HP08392-01
Project Title: Individualized Information Literacy Skills Improvement Organization
Applicant Organization: University of Tennessee Health Science Center, College of Nursing
Address: 877 Madison Avenue, Room 629; Memphis, TN 38 163-0001
Project Director: Cynthia K. Russell, PhD
Phone: 901-448-6158
Fax: 901-448-4121
Email: crussell@utmem.edu
Organization Website: http://www.utmem.edu/nursing/
Project Period: 07/01/2007 — 06/30/2010

Abstract Narrative: The purpose of the Learning Information Seeking and Technology for Evidence-based Nursing practice (LISTEN) program (E3) is to use individualized learning strategies within web-based interactive multi-media training modules to improve the information literacy competencies, i.e., information technology, information seeking, and information application attitudes, knowledge, and skills, of undergraduate and graduate nursing students and practicing workforce nurses. The LISTEN program will first target students in the professional entry and graduate programs at the University of Tennessee Health Science Center College of Nursing (N825). In its second phase, LISTEN will be delivered to nurses employed at the Memphis Veterans Affairs Medical Center, one of our community partner institutions (N=3 18). We plan to reach at least 75% of the nursing students (n619) and at least 50% of the nurses (nl60). The project will be sustained through its continuation in the College of Nursing and the Memphis VAMC and its deployment as a web-based nationwide continuing education program.

While the application of evidence-based nursing practice (EBNP) is fundamental in the realization of the goals addressed in Healthy People 2010, nurses must first be able to access EBNP resources in order to implement evidence-based strategies. The LISTEN program will make this possible by assuring that students and nurses have required specific information technology, information seeking, and information application competencies. The web-based modules will incorporate video, text, audio, and graphics files, designed for interactive and engaging self-paced individualized learning. The modules will support conditional delivery (sequencing or branching) of participants’ progression through the content, permitting individualization of the learning experience. The design and delivery of the LISTEN modules via synchronous group or asynchronous individual methods will ensure that participants have active experiences with the material that is appropriate for their unique individualized learning needs.

In addition to the 3 web-based modules, the LISTEN program includes a (a) project website, with resources for information technology, information seeking, and information application, as well as best practices for EBNP and an EBNP tip of the month, (b) listserv for communication among participants and project leadership, and (c) blog to post content to engage participants and potential participants in dialogue about information literacy competencies. These online resources will help expand participants’ applied information literacy competencies and demonstrate the importance of life-long learning about new technologies.

Increasing participants’ information literacy through an individualized learning approach has the potential to benefit the appropriate supply of nurses (BHPr Goal 1), have a positive effect on health disparities (BHPr Goal 2), assure quality of care and improve the competencies and outcomes of nurses and students (BHPr Goal 3), and improve the infrastructure to support an efficient and effective nursing workforce (BHPr Goal 4). Through improving learners’ information literacy skills, the LISTEN program will enhance the abilities of students and nurses to provide evidence-based nursing care that will result in positive patient outcomes, including improved patient care and improved patient safety, as well as positive nursing outcomes, such as increased confidence, improved productivity, and enhanced efficiency.

Washington

Grant Number: D11HP08378-01
Project Title: Undergraduate Infectious Disease Curriculum Enhancements
Applicant Organization: University of Washington School of Nursing
Address: University of Washington, Box 357266, Seattle, WA 98195-7266
Project Director: Tern Simpson, PhD, RN
Phone: 206 221-6327
Fax: 206 543-4771
Email: tsimpson@u.washington.edu
Organization Website: http://www.son.washington.edu/
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: Although infectious diseases threaten local and global health, our Bachelor of Science in Nursing (BSN) students and others across the US voice low confidence in preparation for care due to limited availability of patients with infectious disease. Students need opportunities to care for the virtual patient with an infectious disease, analyze case scenarios, dialogue with experts in state and global hubs, and engage in value-added learning (Education Priority E-3) . With faculty and local experts, seasoned Web staff, and worldwide linkages to experts in endemic areas, we propose to develop, implement, and evaluate infectious disease course enhancements using interactive learning technologies for our BSN curriculum that will be available on the Web for other schools to use. Compared with a baseline singlecohort of 100 BSN students who do not receive course enhancements, Project Objectives (BHPr Goals 2,3) (Healthy People 2010 Goals 1,2) for up to 3 cohorts of 100 BSN students/cohort, with interactive learning technologies underlined, are to: 1) Strengthen all students’ knowledge and confidence in clinical skills by the end of their senior year through creating 6 virtual cases (simulated manikin, actor model, Web case studies) about infectious diseases (malaria, TST conversion, HIV risk communication, hepatitis, AIDS/TB, food-borne outbreak) to assess, identify health problems, plan and evaluate care. 2) Engage all students in at least one seminar discussion on infectious diseases across each of 5 clinical rotations by equipping clinical faculty with scenario toolkits (scenario, discussion prompts, infection control expert insights, references, best practice guidelines). Rotation scenarios include medical (TB hospital admission), pediatric (measles in emergency room), obstetric (vertical transmission of HIV or Hepatitis C), community health (migrant worker health), and psychiatric (HIV drug adherence in IV drug abuser). 3) Enrich all students in perspectives about care systems, cultural, and research by the end of their senior year by bridging four class sessions with remote connections through live, two-way Web dialogue with nurse clinicians and investigators in areas endemic for infectious diseases in our state (migrant and Native American health) and around the world (evidence based preventions for emerging diseases in Hong Kong; HIV treatment adherence and care in Kenya). 4) Offer 6 optional course-linked value-added learning opportunities that at least one-third of students will select to deepen knowledge of infectious diseases (example: Jeopardy game on pathophysiology of infectious disease). Expected program outcomes are increased knowledge, self confidence, and value of infectious disease nursing practice; increased interest in and intent to serve populations vulnerable to infectious diseases, and; a description of students’ learning profiles of infectious disease experiences, as compared with a baseline cohort of 100 non-project BSN students who do not receive curriculum enhancements. Program baseline-to-completion, course-linked, enhancement-specific evaluation methods and journey maps will be used to measure program outcomes. Funding preference is requested to strengthen BSN care of vulnerable populations at risk for developing or transmitting infectious diseases (i.e., homeless, refugees, uninsured, migrant worker health), which substantially benefits the underserved.

Grant Number:  D11HP08386-01
Project Title: Targeting Everett’s Health Disparities
Applicant Organization: University of Washington School of Nursing
Address: Biobehavioral Nursing & Health Systems, Box 357266, UW, Seattle, WA 98195
Project Director: Eleanor F. Bond, PhD, RN, FAAN
Phone: 206 616 1964
Fax: 206 543 4771
Email: rebond@u.washington.edu
Organization Website: www.son.washington.edu
Project Period: 1 July 2007 to 30 June 2012

Abstract Narrative: This project responds to NEPR Purpose P1: expand a nurse practice arrangement (N PA) in a non-institutional setting to demonstrate methods to improve primary health care access in a medically underserved (MU) community. University of Washington (UW) School of Nursing (SON) and Snohomish County (SnoCo) leaders partnered to plan Providence-Everett Healthcare Clinic (PEHC), a NPA providing excellent, affordable healthcare services for the MU. We request resources to expand the quantity, quality, and scope of PEHC services, expand educational opportunities for undergraduate (UGr) and graduate (Or) students, and recruit SnoCo residents into nursing. The project will demonstrate methods by which communities and nursing schools can collaborate to provide exemplary MU primary care services and education opportunities.

Summary - Need: SnoCo has large, diverse MU populations. Particularly in need of services are low income elderly and children. SnoCo’s MU populations have complex health problems, with co-morbid physical and mental health conditions. Many SnoCo areas are designated as Health Professional Shortage Areas for Primary Care. Needed are nurses and advanced practice nurses prepared to provide health care services. Proposed services: The project provides expanded primary care services. Population groups served: Targeted are elderly and pediatric patientsfrom low income, immigrant (Eastern Europe, Vietnam, Korea), and migrant (Hispanic) families. Aims: Project objectives (relevant BHPr goal) are: (1) Reduce SnoCo‘s health disparities; increase access to/strengthen quality of primary care services; emphasize pediatric, geriatric, and mental health services ( BHPr Goal #2, eliminate health disparities ). (2) Expand structured UGr and Gr nursing education experiences, improve student cultural competency (BHPr Goal #3, improve health professions workforce’s knowledge, skills, competencies, outcomes). (3) Recruit SnoCo residents into nursing education programs (emphasize underrepresented groups, economically disadvantaged). ( BHPr Goal #1, Assure appropriate health professions workforce supply, diversity, composition, distribution). (4) Create innovative approaches to MU care; evaluatecost/efficacy of care; implement evidence-based protocols and computer-tracking of adherence, clinical outcomes, improve financial stability and sustainability. (BHPr Goal #4. Strengthening Public Health). Methods: Nurse faculty-clinicians will practice and teach at PEHC. Faculty experts (pediatrics, gerontology, mental health, cultural competence) will guide inclusion of these content areas into clinic service lines. An electronic information system will integrate current evidence-based practice standards, providing a framework to evaluate clinical and fiscal variables. Faculty, staff, and students will complete cultural-competence training. Cultural-competency experts will advise, consult. The SON recruiter will target SnoCo residents. Evaluation : Faculty, students, staff, and patients will evaluate PEHC. Clinical and organizational indicators will be tracked to determine quality and cost-effectiveness. Consultants will evaluate cultural sensitivity. A fiscal advisory committee will conduct financial analyses (patient encounters, cost of care, visit volume/intensity, provider & student data). SON will track students trained (20-30 UGr; 20-30 Gr; 10-12 project students annually) and post-graduation practice in MU communities (target: 75%). The project will substantially benefit underserved and rural populations; thus, statutory funding preference is requested. PEHC activities will be implemented during the first quarter of funding.

Grant Number: D11HP07311-02
Project Title: Expanded Practice in Medical-Surgical Nursing
Applicant Organization: University of Washington School of Nursing
Address: 155 NE 100^th Street, Suite 306, Seattle, WA 98125-8014
Project Director: Ruth F. Craven, EdD, RN, BC, FAAN
Phone: 206-543-1047
Fax: 206-543-6953
Email: ruthc@u.washington.edu
Organization Website: www.uwcne.org
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This proposal is submitted for consideration under Title VIII of the Public Health Service Act, Section 831, as amended by the Nurse Reinvestment Act, 2002, PL 107-205, authorizing grants to strengthen and enhance the capacity for nurse education, practice and retention to address the nursing shortage. The Nurse Education, Practice and Retention (NEPR) program purpose of this project is Purpose P3, which is to provide managed care, quality improvement and other skills needed to practice in existing and emerging organized health care systems. This project addresses purpose P3 by I) preparing nurses for enhanced practice and national certification in medical-surgical nursing, 2) increasing access to medical-surgical nursing continuing education for nurses who are from and/or work with diverse and underserved populations in urban and rural settings, and 3) mentoring experienced medical-surgical nurse leaders to increase the number, diversity, and retention of certified medical-surgical nurses in the workforce. The project supports the efforts of hospitals and medical centers in promoting high standards of medical-surgical (med-surg) nursing services for their patients and educational opportunities for their nursing staff.

Competing continuation funding is requested to enable the University of Washington School of Nursing and the University of Washington Medical Center in partnership with regional urban and rural medical centers to expand access for registered nurses to a series of unique continuing education offerings collectively entitled the Medical-Surgical Education Program (MSEP). Components of the MSEP include an intensive review course to improve practice and promote certification, an annual 2-day med-surg nursing conference, quarterly nursing grand rounds, and online self-study short courses. The MSEP was initiated with a URSA training grant (2004-2007) and, in the first two years, has exceeded attendance predictions in all offerings by 187%. The core review course has exceeded predictions by 425% and has a growing list of hospitals (“agencies”) waiting to participate. Because of its successful partnerships with agencies in diverse urban and rural communities, the MSEP is poised to develop delivery systems that will expand access to med-surg nursing education throughout the Pacific Northwest.

The MSEP has demonstrated its ability to 1) augment the knowledge and skills of registered nurses in geographically diverse clinical settings, 2) assist nurses, including nurses among underrepresented and underserved populations, in obtaining and maintaining national certifica­tion in medical-surgical nursing, 3) enable nurses to assume expanded roles and responsibilities in new and changing interdisciplinary environments, and 4) promote evidence-based practice. Proposed enhancements include adding more participating agencies, establishing multi-agency sites, offering a web-based asynchronous format of the core course, adding conferences on diversity and mentorship, offering nursing grand rounds to rural hospitals, and mentoring medical-surgical nurses to assume leadership as MSEP coordinators in their regions. This continuation project will provide education to a minimum of 1373 nurses and model innovative approaches to improving practice and promoting certification through continuing education.

Wisconsin

Grant Number: D11HP08384-01
Project Title: Wisconsin Nurse Residency Program: Continuing Partnerships to Support New Nurses’ Seamless Transition into Practice
Applicant Organization: Marquette University
Address: P.O. Box 1881, Milwaukee, WI 53201-1 881
Project Director: Marilyn Bratt, PhD, RN
Phone: 414-288-3840
Fax: 414-288-1939
Email: marilyn.bratt@marquette.edu
Organization Website: www.wnrp.org www.marguette.edu
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: This proposal addresses the legislative purpose regarding developing and implementing internship and residency programs and seeks continuation funding to build on the success and further advance the outcomes of the currently funded Wisconsin Nurse Residency Program (WNRP), which is in the final year of its three-year funding cycle. Needs: Evidence regarding the outcomes of residency programs continues to be in evolution. There is also a continued need to clearly define the parameters and core elements of these programs and to have a delineated process in which graduates can be effectively integrated into their professional role. Particularly in cost-conscious organizations, which are operating with shrinking staff development budgets, the need to create programs that afford the best return on investment is paramount. More importantly, it is vital to measure the long-term impact of these programs. There is also a significant need for well-trained preceptors. Often preceptors are asked to precept a new nurse by default, by virtue of being the only nurse available, rather than by choice. Particularly in rural hospitals, every nurse needs to be trained to work with new nurses.

Proposed Services: Focused on expanding and enhancing the programmatic elements of the current phase of the WNRP, the overall purpose of proposed project is to develop and implement a more comprehensive, long-term and seamless model that supports new graduates’ effective transition into practice and building of clinical expertise. Particularly through training activities for experienced nurses as preceptors and clinical coaches using simulation learning technology, this proposed project in conjunction with the current WNRP elements offers a more dynamic and seamless model to meeting the developmental needs of the new graduate from the point of hire throughout the first 18-24 months of practice. More specifically the purposes of the proposed project are to: (a) enhance the current WNRP structured nurse resident learning curriculum with simulation technology; (b) effectively train preceptors and clinical coaches using simulation learning technology, and (c) develop and evaluate the effectiveness of the program model to provide seamless support. The model proposed by this project represents a continuous cycle of supporting learning, professional development, leadership and retention of nurses within the organization and the profession. Population to be served: Marquette University plans to continue collaboration through established and ongoing partnerships with rural and urban acute care providers located across Wisconsin. The project has the potential to impact nurses in over 40 hospitals, of which over 60% are critical access hospitals. The rural partners include Rural Wisconsin Health Cooperative (RWHC), which represents 31 rural hospitals Funding Preference: As this project substantially benefits rural populations, we are requesting a statutory funding preference.

Wyoming

Grant Number:  D11HP08370-01
Project Title: Developing Public Health Leaders: ADN to BSN Education in Wyoming
Applicant Organization: University of Wyoming School of Nursing
Address: Dept. 3065, 1000 E. University Ave, Laramie, WY 82071
Project Director: Pamela Clarke, Ph.D., R.N.
Phone: 307-766-6566
Fax: 307-766-4294
Email: pclarke@uwyo.edu
Organization Website: http://www.uwyo.edu/nursing
Project Period: July 1, 2007 – June 30, 2010

Abstract Narrative: The purpose of the project is to continue and expand efforts to promote career advancement for Wyoming nurses from the Associate Degree (ADN) to the Baccalaureate Degree (BSN) through an innovative BSN completion program designed to develop strong public health leaders for underserved rural communities in the state. Initial project funding was awarded by grant # D65HP03149 for the project period July 1, 2004 to June 30, 2007.   

This project, known as “LEAP” (Leadership Education to Advance Practice), has targeted ADN nursing students and AD-prepared nurses to facilitate their completion of a BSN degree. The LEAP project offers community on-site recruitment at regional health care settings and community colleges, on-site advising, mentoring and two specially designed courses. It is currently offered in two regions of the state. This continuation proposal will: 1) to continue, expand and revise the LEAP project to facilitate program completion for students identified in years 01-03, 2) to increase and expand access and enrollment in the LEAP program from two Regions to the entire state of Wyoming, 3) support implementation of a range of on-site modules to increase personal involvement in the predominantly on-line program, and 4) expand the advising and mentoring component of the project to promote long term career planning.

Wyoming is the 9^th largest state in the United States geographically, but has the lowest population of all the states. This makes the state largely frontier, requiring travel over long distances of undeveloped land in order to connect with resources and health services. These same characteristics serve as barriers for nurses prepared at the ADN level to participate in higher education. The LEAP project has made significant strides in overcoming these barriers for nurses in the Southwestern and West Central regions of the state through providing on-site recruiting of nurses and nursing students, online courses, personal and direct advising and mentoring. However, there are three other major regions in the state that are not currently served by the LEAP project. Therefore, expanding the LEAP to these other regions is a major objective of this continuation project. Services will continue to be those already developed in the current LEAP. In addition, this project will implement revised class activities within the core LEAP nursing courses in order to provide a range of on-site experiences, particularly in the area of cultural diversity, in order to foster collegiality and skills for on-line education. And this project will expand the mentoring and advising components of the project to encourage long term career planning and facilitate transition into the workforce.

Populations to be served in the broadest sense are the people of Wyoming because this project will increase the number of highly qualified baccalaureate prepared nurses in the state. Populations directly targeted for career ladder bridging will be currently enrolled ADN students in any of Wyoming’s 6 community colleges, registered nurses prepared at the ADN level in the state, and high school students and community members who might be considering health care as a career.