Alabama

Grant Number: D11HP09570-01
Project Title: Reshaping Our Future: BMCS RN Residency Program
Applicant Organization: Baptist Medical Center South
Address: 2105 East South Boulevard, Montgomery, Al 36116
Project Director: Rossiland Harris, MSN, APRN, BC
Phone: 334-286-2821
Project Period: July 1, 2008 — June 30, 2011

Reshaping Our Future: BMCS RN Residency Program is a competing application, which focuses on the NEPR Education Priority Area, Purpose E-2: Developing and implementing internship and residency programs to encourage mentoring and the development of specialties.

The need for a stable nursing workforce that is confident and competent is a major concern at Baptist Medical Center South. On a yearly average, of the approximately 140 new hires in 2006, 54 uncontrolled terminations occurred (3 9%). This pattern of turnover has had a significant escalation of contract labor cost due to a growing demand of health care in Montgomery, Alabama and its surrounding areas, a decrease in newly licensed nurses, a higher hospital census with greater acuity. The hospital has experienced a significant escalation of over 183% in contract labor costs over the past three fiscal years. Contract labor costs have increased from $3.4 million in fiscal 2005 to $9.7 million in fiscal year 2007. Each specialty area has incurred considerable increases in contract labor dollars year after year. This program targets RNs with less than 6 months experience and RNs changing specialties. Nurses selected for the program will be provided a comprehensive mix of structured clinical and theoretical education above and beyond the 90-day orientation with a clinical coach. BSN newly licensed will have 12 months of nurturing and support. The experience RN changing specialties will benefit from an individualize specialty track focused on the needs of the RN.

The program builds on the premise that a planned residency program will influence job satisfaction, improve retention, positively influence patient outcomes, and contribute to the development culturally responsive nurses. Within the RN Residency Tracks, residents will progress through basic and advanced skills through the human simulation lab, leadership, and critical thinking skills in a multicultural health care focus. Throughout the program, residents will have preceptor/coaches and mentors.

The proposed project will build upon the foundation goal of(a) to create competent practitioners and (b) to alleviate the nursing shortage at BMCS by facilitating the transition of RNs to competent, confident, and satisfied acute care nurses for the provision of safe care to an underserved, multicultural patient population in part of the Black Belt region and Montgomery of Alabama. This traditionally underserved population in Alabama is fifth in the nation for premature death from heart disease, seventh for stroke and continues to be second in the nation in neonatal mortality. This population also demonstrates the fastest rate of growth in obesity and diabetes in the state.

The key outcome, Nurse Retention, will be positively affected through the goals of the proposed project. Specifically the proposed project will target BHPr goal #3: Assure Quality of Care: Improve the knowledge, skills, competencies and outcomes of health professions workforce.

Arizona

Grant Number: D11HP09753-01
Project Title: Leveraging Educational Technology for Evidence-Based Practice
Applicant Organization: Arizona State University
Address: 500 N 3^rd Street, Phoenix, AZ 85004-0698
Project Director: Debra Hagler, PhD, APRN, BC, CCRN, CNE
Phone: 602 496-0802
Fax: 602 496-0921
Project Period: July 1, 2008 — June 30, 2011

The goal of Leveraging Educational Technology for Evidence-Based Practice (LET-EBP) is to improve the quality and delivery of nursing education through expanding use of educational technology (NEPR Purpose E3) for pre-licensure students.

The Institute of Medicine’s Roundtable on Evidence-Based Medicine has set a goal for ninety percent of clinical decisions to be supported by the best available evidence. Appraisal of the best evidence for planning nursing care, development of clinical expertise, and consideration of the patient’s preferences and cultural values requires integration of learning across the cognitive, affective, and psychomotor domains.

The innovation of this proposal lies in expanding use of educational technology to promote student learning through deliberate development of faculty expertise, creation of effective instructional design, mentorship for clinical preceptors, and collaboration with interdisciplinary partners.

Efforts to address the nursing shortage by increasing student enrollment have led to challenges in contracting sufficient numbers of appropriate clinical learning sites, impacting clinical practice opportunities. Using the powerful educational strategy of high-fidelity simulation, students develop cognitively as they make assessments and analyze data for evidence-based decision making, develop affectively as they practice cultural responsiveness in the context of clinical decisions and care, and develop psychomotor coordination as they have an opportunity to practice provide hands-on care for fragile patients including children, the elderly, and the critically ill.

LET-EBP supports four groups of participants. Over 1000 undergraduate pre-licensure students will practice evidence-based clinical decision making in the context of caring for patients from a variety of ethnic cultures. Nursing faculty from the college and from other regional programs will learn to apply best evidence to develop teaching plans that support technology-enhanced learning activities. Staff nurse preceptors in clinical agencies will support students in learning evidence-based clinical practice at the bedside. Multidisciplinary health care team members will explore the use of simulation and other educational technologies to support health education and patient safety initiatives. Through support to these four groups of participants, LET-EBP expands and enhances the infrastructure and knowledge resources for effective nursing education.

Arizona is challenged by a more rapid population increase in rural and urban areas, a more rapid increase in ethnic diversity with accompanying health disparities, and a relatively more acute nursing workforce shortage than most areas of the United States. A funding preference based on service to rural and underserved populations is requested.

Grant Number: D11HP09761-01
Project Title: KySS Fellowship for NPs in Underserved U.S.: Improving Child & Teen Mental Health
Applicant Organization: Arizona State University College of Nursing & Healthcare Innovation
Address: 500 N. 3^rd Street, Phoenix, Arizona
Project Director: Bernadette Mazurek Melnyk, PhD, RN, CPNP/NPP, FAAN, FNAP
Phone: 602-496-2200
Fax: 602-496-0873
Project Period: July 1, 2008 — June 30, 2011

This proposal addresses HRSA’s Nurse Education, Practice and Retention Program by enhancing the knowledge and skill set of advanced practice nurses (i.e., primary care pediatric nurse practitioners IPNP5I and family nurse practitioners [FNP5I) to provide care for a highly underserved, high-risk population of culturally diverse children and teens with common mental health problems (Purpose P2). One in 4 children and adolescents (i.e., 15 million) in the United States (U.S.) have a mental health problem that interferes with their functioning at home or at school, yet only 20 to 25 percent of these children receive any treatment. Significant health disparities also exist in the receipt of mental health services, with a disproportionate number of Hispanic and African-American children affected. Furthermore, there is a shortage of 30,000 child psychiatrists across the U.S., which is contributing to the severe gap in child and adolescent mental health services.

Advanced practice nurses (APNs) who are primary care providers (PCPs), such as PNPs and FNPs, are in a unique position to identify and manage common behavioral and mental health problems among children and adolescents as approximately 75 percent of children with mental health disorders are seen in primary care settings. However, although the burden of assessing and treating children and teens for mental health problems has largely fallen to PCPs, findings from recent studies that include our recent needs assessment have supported that PCPs report inadequate knowledge of screening and early intervention practices for these problems.

This proposal supports the development, implementation and evaluation of a web-based KySS (Keep your children/yourself Safe and Secure) Fellowship Continuing Education (CE) Program aimed at preparing PNPs and FNPs to accurately screen for, identify and deliver early evidence-based interventions for children and adolescents experiencing common mental health problems. The fellowship program will be the first of its kind in the U.S. and a collaborative initiative between the Arizona State University College of Nursing & Healthcare Innovation and the National Association of Pediatric Nurse Practitioners’ (NAPNAP) KySS Program, a national initiative founded and launched by the project director for this application in 2001 with a purpose of promoting the mental health of children and teens as well as enhancing healthcare providers’ ability to screen for and deliver early evidence-based interventions for children and youth with common mental health problems. The KySS Fellowship program will provide an internet-based CE program that integrates 20 web-based learning modules along with clinical practice experiences in the NPs’ clinical practice settings in order to provide opportunities for the participants to put into practice the content from the on-line educational modules and enhance their skills in assessing and managing common mental health problems in culturally diverse high risk children and teens, especially those in rural and underserved areas.

California

Grant Number: D11HP09552-01
Project Title: Clinical Simulation Technology in Professional Nurse Education
Applicant Organization: Kaiser Foundation Hospitals
Address: 280 West Mac Arthur Boulevard, Oakland, CA 94611
Project Director: Sylvia Bertram, RN PhD
Phone: (510) 752-5018
Fax: (510) 752-8080
Project Period: 07/01/2008 – 06/30/2011

1. Proposed Grant Project: Kaiser Foundation Hospitals (hereafter referred to as Kaiser Permanente Oakland Medical Center) proposes the Clinical Simulation Technology in Professional Nurse Education project. This project will evaluate the effectiveness of clinical simulation-based education as a teaching methodology in order to assess competencies of registered nurses (RNs), reduce errors, and ultimately improve patient safety and health outcomes. This project seeks to educate RNs from two organizations -- a non-profit acute care hospital and a publicly-funded county hospital -- in the fundamentals and use of clinical simulation technology, while integrating this learning into scenario-based simulation training for specific nursing content areas (e.g., pediatrics, intensive care, etc.). Simulation technology will also be used to educate RNs who serve as mentors for new graduate nurses in order to increase their skills and cultural sensitivity.
2. Needs to be Addressed: Although progress is being made in California to address the nursing shortage, hospitals face recruitment challenges as well as high vacancy and turnover rates. HRSA has designated hospitals as “critical shortage facilities.” The growing ratio of new graduate nurses to experienced nurses as they enter the workforce requires that hospitals develop educational programs to bridge the gap from school to work while also offering innovative programs to address the need for ongoing assessment, validation, and development of RN skills and competencies. The integration of simulation technology (i.e., SimMan^TM) into ongoing professional nurse education provides a unique opportunity to address this need. Schools of nursing are adopting this technology to lessen the amount of time a student nurse needs in the actual clinical environment. However, the dearth of literature and evaluation of simulation technology as a means of educating professional nurses in the work setting presents a cutting edge opportunity to evaluate the effectiveness of simulation technology in assisting RNs with honing their skills and competencies in a safe setting.
3. Proposed Services: The project will provide a pre-requisite Foundations of Simulated Training course to 1,167 RNs. This training will lead into content-specific simulated training in the areas of new hire orientation, mentor training, critical care nursing, medical/surgical nursing, pediatric nursing, and neo-natal intensive care nursing among others. Kaiser Permanente will also develop new simulation technology clinical scenarios and training in some of these specific content areas where these do not currently exist. Simulation-based technology training will be offered within Kaiser Permanente’s Oakland Medical Center centrally located facility to enhance access to training by the RNs attending. All training will be completed on regular work time and participants will receive a certificate of completion and continuing education credits for training.
4. Population Group(s) to be Served: The proposed project will target newly hired and incumbent RNs employed by the Kaiser Permanente Oakland Medical Center and the Alameda County Medical Center. At minimum, 60% of RNs will be from underrepresented communities.

Grant Number: D11HP09564-01
Project Title: Expansion of the Glide Health Services Nurse Managed Health Center
Applicant Organization: University of California, San Francisco, School of Nursing
Address: UCSF School of Nursing, Department of Community Health Systems 2 Koret Way, San Francisco, CA 94143-0608
Project Director: Patricia Dennehy, Assistant Clinical Professor
Phone: (415) 674-6145
Fax: (415) 885-8512
Project Period: July 1, 2008 — June 30, 2011

The purpose of this Nurse Education, Practice and Retention grant proposal is to expand and enhance the primary health care services to a medically underserved, high-risk, predominately homeless client population served by a University of California, San Francisco (UCSF), School of Nursing faculty practice arrangement at Glide Health Services (GHS) in San Francisco’s Tenderloin District (NEPR Purpose P1). This project will use Division of Nursing grant funding to support nursing leadership and clinical expertise to achieve the GHS mission to provide the highest quality healthcare to a client population that has significant health disparities and faces numerous barriers to care, while simultaneously continuing to provide a valuable student clinical nurse training experience designed to produce a diverse and culturally responsive health workforce.

Established in 1997, GHS is currently a Federally-Qualified Health Center (FQHC) and federally-supported Health Care for the Homeless (HCH) provider site that is well integrated into the “safety net” of public and private agencies serving San Francisco’s homeless and medically underserved residents. As GHS has developed, we have implemented a full range of integrated primary, mental health, substance abuse, complementary and preventative services designed to address the complex and often critical health needs of our clients. Clinical training opportunities for UCSF pre-licensure and graduate nursing students, which are closely linked with their academic experiences, have increased during this period as well. The activities of this project will be augmented by GHS’ participation, under the Institute of Nursing Centers (INC), in a national pilot project to improve the quality of care in vulnerable populations through the implementation of electronic health records.

The Objectives for GHS during this project period are:

Project Objective 1: Improve access to high quality integrated primary care services provided by Glide Health Services, a nurse managed center, to the medically underserved residents in San Francisco’s Tenderloin District through: population- and disease-specific strategies; effective use of clinical staffing and Information Technology resources; outreach and linkages to community resources. (BHPr Goal 2, HP 2010)

Project Objective 2: Provide and expand student clinical nursing experiences that emphasize leadership, cultural competence, interdisciplinary care, community partnerships, population-based chronic care and advocacy through the utilization of key concepts of Healthy People 2010 (HP2010) related to access and health disparities (BHPr Goal 1).

Project Objective 3: Ensure the long-term sustainability of GHS through the continued development of diverse public and private sources of revenue, including grants, contracts, reimbursement, in-kind support, charitable contributions and client sliding fee scale payments.

Florida

Grant Number: D11HP05201-04
Project Title: Enhancing Education and Health Care at Archer
Applicant Organization: University of Florida
Address: P0 Box 100197, Gainesville, FL 32610-0197
Project Director: Myra D. Williams, PhD, RN, Associate Dean for Clinical Affairs
Phone: 352-273-6335
Fax: 352-273-6519
Project Period: July 1, 2005 – June 30, 2011

“Enhancing Education and Health Care at Archer” addresses NEPR Practice Purpose P1 and BPHr Goals 1, 2 and 3, and includes activities related to Healthy People 2010 goals, focus areas, and objectives. This Continuation Project will increase access to quality health care services for rural, medically underserved residents of north central Florida and will increase the availability of structured clinical experiences for nursing students in a medically underserved area. Expansion of Archer Family Health Care (AFHC), a comprehensive nurse-managed primary care and community health nursing center follows relocation of the clinic to a larger facility. Project funds will support additional personnel costs and purchase of additional supplies necessary to increase patient care visits by 150%, increase the number of clinical days that graduate students practice with faculty members by 200%, and increase the number of baccalaureate program students who have community health clinical experiences in the rural Archer area by 30% over baseline numbers. In addition, the Project will continue to provide a quality community health education program to area residents and increase the percentage of nursing graduates who practice in medically underserved areas. A variety of funding sources will enable the Project to be self-sufficient following the three-year Continuation Grant period.

Idaho

Grant Number: D11HP11127-01
Project Title: Rural Nurse Residency
Applicant Organization: Idaho State University School of Nursing
Address: 921 South 8^th Ave. Stop 8101, Pocatello, ID. 83209-8101
Project Director: Deana L. Molinari PhD, RN
Phone: 208-282-2982
Fax: 208-282-4476
Project Period: July 1, 2008 — June 30, 2011

The Rural Nurse Residency is a proposal for the E2 NEPR purpose. One of primary goals of Rural Healthy People 2010 (Southwest Rural Health Research Center) is the development of a skilled workforce. Rural nurses need a residency in order to develop basic practice competencies. An innovative delivery model can overcome the barriers preventing rural residencies in the past.

Rural nurses are generalists with advanced assessment and management skills. A residency is needed because the advanced skills are not taught in basic education programs. Nursing students need to learn more about communication, inter-professional collaboration, leadership, and advanced crisis assessment and management to survive in rural agencies. Chief nursing officers state 25% or more new graduates leave employment within the first year (Washington State University, 2003; Idaho State University, 2006).

Western Washington Area Health Education Center, Montana Office of Rural Health and Health Education Center, Public Hospital Cooperative of Southeastern Idaho and Idaho State University (ISU) will deliver the residency to Wyoming, Montana, Idaho and Washington health care provider agencies. The innovative model utilizes a central education agency (ISU) to coordinate rural experts and control the quality of the educational materials requested by participating agencies.

The project trains preceptors, and uses standardized evaluation methods and tools. Residents will receive expert rural information via telemedicine, and both real time and asynchronous web technologies. The residents’ four-month education consists of four elements- 1) Education: 64 hours of distance learning seminars- 7 core curriculum sessions and 7 electives; 2) A Preceptored Clinical Experience of 104 hours; and 3) Just in Time Information for Evidence-Based Practice: A personal digital assistant (PDA) and library subscription. 4) A simulation workshop for skills competency testing.

Small agencies request the residency, design the learning plan, supervise, motivate, and evaluate the residents. The curriculum provides electives to meet the needs found in many acute and non-acute care settings. Chief nursing officers select the preceptors who are then trained by project staff and conduct the resident’s clinical education using the project’s educational processes and tools.

Illinois

Grant Number: D11HP09760-01
Project Title: Tech-ENABLED
Applicant Organization: Eastern Illinois University
Address: 600 Lincoln Avenue Charleston, IL 61920
Project Director: Dr. Dianne Nelson
Phone: (217) 581-7049
Fax: (217) 581-7050
Project Period: July 1, 2008 — June 30, 2011

Eastern Illinois University is proposing a project that will serve purpose El: Expanding the enrollment in baccalaureate nursing programs. Specifically, the university proposes to address a regional shortage of baccalaureate-educated nurses in its rural region by significantly expanding a new RN-to-BSN completion program.

Eastern Illinois University is requesting a funding preference for two reasons: (1) The project will benefit the rural population in a ten-county region. (2) The project will benefit an underserved population.

Eastern Illinois University proposes a project starting date of August 22, 2008, a date that is well in advance of the required date of January 31, 2009.

Eastern Illinois University is centrally located in a 10-county rural region of east-central Illinois. Residents of the area are more aged than average and face above-average mortality rates from heart diseases and cancer. In this region, baccalaureate-educated nurses are in short supply because—in part—access to education is limited.

In order to increase the supply of baccalaureate-educated nurses in its rural region, Eastern Illinois University proposes a project with three objectives:

Objective 2

Increase the capacity of Eastern’s RN-to-BSN program by increasing the number of full-time ~irsing faculty from 1 to 2 by 8-22-2009

Kentucky

Grant Number: D11HP09549-01
Project Title: Emerging Medias in Distance Education
Applicant Organization: Frontier School of Midwifery and Family Nursing
Address: 195 School Street, P.O. Box 528 Hyden, Kentucky 41749
Project Director: Susan E. Stone, DNSc, CNM, FACNM — President and Dean
Phone: (859) 253-3637 ext. 5010
Fax: (859) 514-1347
Project Period: July 1, 2005 – June 30, 2011

The Frontier School of Midwifery and Family Nursing (FSMFN) began providing advanced nursing education in a distance setting in 1989 making FSMFN a pioneer in the field of distance education for graduate nursing students. FSMFN strives to offer the most innovative approaches to delivering distance education and is seeking funding to support these efforts. FSMFN provides advanced educational preparation for nurses who seek to become nurse-midwives (CNM), family nurse practitioners (FNP), or women’s health care nurse practitioners (WHCNP) by providing a community-based distance graduate program leading to a Master of Science in Nursing (MSN) or a post-master’s certificate. The FSMFN meets the needs of prospective nurse-midwives and nurse practitioners who are not able to leave their home communities to obtain the graduate education they desire to fulfill their professional aspirations. Using local clinics, hospitals and preceptors allows students to get the hands-on clinical experience required for these health care professions while remaining in their home communities. Since adopting distance education modalities in 1989, FSMFN has graduated over 1200 nurse-midwives and nurse practitioners representing all 50 states.

FSMFN offers a quality, accredited program of study for students that may not have access to traditional campus-based programs. The distribution of FSMFN students is vast, with 45% residing in rural areas as defined by the federal government, 79% residing in Health Professional Shortage Areas (HPSA) and 75% residing in Medically Underserved Areas (MUA) (FSMFN Student Management System 2007). FSMFN is a source for quality advanced nursing education to meet the needs of these students. In order to continue meeting the needs for current and future students, FSMFN must not only keep up with current technology utilized in the higher education and nursing fields, but must also be innovators. FSMFN is applying under Purpose E3: Providing nursing education in new technologies, including distance-learning methodologies.

This project seeks to provide FSMFN with critical funding that will support several projects that will comprehensively enhance the FSMFN educational process. This project will integrate new technologies into each facet of a student’s educational experience. The overarching goal of the FSMFN Project is to graduate technologically competent advanced practice nurse-midwives and nurse practitioners to provide quality health care throughout the country with a focus on rural and medically underserved areas. FSMFN will accomplish this goal by introducing new technologies for delivery of didactic educational content by using new medias and mobile devices, expanding access to electronic resources available including Up-to-Date and Epocrates, and utilizing an enhanced learning management system, instructional and interactive videos, and virtual simulation equipment to enhance critical thinking skills through constructivist learning strategies.

Michigan

Grant Number: D11HP09565-01
Project Title: Simulation Technology Electronic-informatics Preparatory Systems: STEPS
Applicant Organization: University of Detroit Mercy-College of Health Professions
Address: 4001 W. McNichols Road Detroit, Michigan 48221
Project Director: Suzanne Guzelaydin
Phone: (313) 993-2453
Fax: (313) 993-1271
Project Period: July 1, 2008 — June 30, 2011

The STEPS program addresses the Bureau of Health Professions Title VIII Nurse Education, Practice and Retention Program Purpose E-3: Providing education in new technologies, including distance learning methodologies. The University of Detroit Mercy, McAuley School of Nursing (MSON) requests funding to implement a uniquely innovative clinical practice program that utilizes simulation case studies that incorporate real-time computerized human patient simulation manikins, an electronic health record system, handheld point-of-care reference resource and tele-health technology. The case studies will include the QSEN: knowledge, skills and attitudes as part of the criteria for evaluating student competency for each clinical student cohort within the MSON program. The technology components of the case studies are vital to the continued advancement of student-centered nursing education in the 21^st Century. These technologies provide convergence of replicable simulated clinical experiences and a foundation of informatics literacy for students to develop knowledge and skill, promote patient safety, decrease clinical errors and promote continuous quality improvement measures. In its plans to develop the STEPS program, the College will enhance infrastructure, integrate informatics technology across our program curricula, and evaluate student outcomes utilizing the STEPS program in preparatory practice. This project is unique in:

• Enhancing nurse educators use of innovative technological advancements in education and clinical practice
• Offering the total scope of patient care from direct to distance care delivery and documentation of the services provided in a life-like real-time clinical practice setting.
• Preparing under-graduate students to utilize emerging informatics technology advancements in clinical practice.
• Enhances the seamless transition from student to practitioner by providing experiences throughout the curricula that simulate actual practice situations.
• Potentially increase job satisfaction and retention within the first three years of employment by providing a foundation of knowledge and skill development that prepared students for the role of clinician.

If funded it is anticipated that student survey will positively validate the program’s focus has had an impact on preparation for role transition. Further, there will be deceased orientation costs incurred by area healthcare facilities as our students will have an operational understanding of informatics and application in practice. We believe this will promote increased job satisfaction and ultimately retention of new graduates in the crucial first three years of employment. This will positively impact on the number of nurses available to practice within our geographic area. Formative and summative evaluation will be used to measure project objectives and outcomes. A statutory funding preference is requested for this project that seeks new funding to meet the needs of preparing baccalaureate nursing students to meet the challenges of the current healthcare environment.

Mississippi

Grant Number: D11HP09551-01
Project Title: Expanding Enrollment in Baccalaureate Level Nursing Education in South Mississippi Through a Dual Enrollment Program
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
Project Period: 07/01/2008 – 06/30/2011

Abstract Narrative: The applicant 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 E1, Expanding Enrollment in Baccalaureate Nursing Programs. The purpose of the proposed project is to expand enrollment in the applicant’s baccalaureate nursing program in order to subsequently increase the number and quality 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) assure 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) through the development of a dual enrollment program with community college nursing programs in the southern region of Mississippi.

The SoN at Southern Miss is in a position to address the issue of health barriers by impacting the supply of baccalaureate prepared nurses in the workforce. The SoN is one of seven baccalaureate nursing programs in Mississippi and graduates the largest number of B SN students in the state. The SoN has programs located in three locations in the southern part of the state: the Hattiesburg campus, Gulf Park campus, and Meridian campus. There are five community colleges with associate degree nursing programs in the southern region of the state. Approximately 20% of the students in these associate degree programs qualify for admission to a BSN program. Applicants to these community college nursing programs typically live in rural, underserved counties and usually remain in these counties to work after graduation. The proposed program is aimed at attracting these community college students to a dual enrollment Bachelor of Science nursing program that would result in the completion of a BSN degree.

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 proposed dual enrollment program. This unique program will allow qualified students to complete a baccalaureate degree in nursing and begin their nursing career prepared at a baccalaureate level rather than the associate degree level.

Mississippi is plagued by poor health outcomes with a high percentage of residents living below the poverty level and lacking access to quality health care. The incidence of diabetes, hypertension, hypercholesterolemia, cardiovascular disease, and obesity is higher in Mississippi than in the rest of the United States. Most Mississippi residents live in rural communities with shortages of healthcare providers. Expanding enrollment in baccalaureate nursing programs and subsequently increasing the quality of registered nurses will ultimately serve to eliminate health disparities by improving the health outcomes of populations in the rural communities in the state.

Grant Number: D11HP09762-01
Project Title: Nurse Managed Medical Homes for School Aged Children in Jackson Mississippi
Applicant Organization: University of Mississippi Medical Center School of Nursing
Address: 2500 North State Street, Jackson, MS 39216
Project Director: Theresa M. Doddato, EdD, RN
Phone: (601) 984-6271
Fax: (601) 815-4119
Project Period: July 1, 2008 — June 30, 2011

The purpose of the project is to expand the University Of Mississippi Medical Center’s School Of Nursing’s (UMSON) present nurse managed center (NMC) in the Jackson Public School District (JPSD) by the addition of two new sites with over 600 children to improve access to primary health care by establishing medical homes for school aged children who are socially neglected, economically deprived and where health disparity is ubiquitous. This would be the first nurse managed medical home for children in the state of Mississippi. The purpose is consistent with the program authorized under Title VII, section 831 of the Public Health Service Act as amended by the Nurse Reinvestment Act of 2002; Public Health Law 107-205;U.S.C. 296p, Purpose P 1. Need: Mississippi leads the nation in the rates of obesity, hypertension, and diabetes and is second in the United States in poverty rate for ages 18 and under. Mississippi exceeds the national rate for uninsured children. Thirty one percent of all uninsured children are without a medical home or personal primary care provider. These startling statistics emphasize the need for creative solutions. Outcome objectives: 1) Expand the current nurse managed center in the JPSD with the establishment of 2 new service sites at Brown Elementary and Rowan Middle schools to reduce health disparity and improve access to primary healthcare in a medically underserved community in Hinds County, Jackson, Mississippi. 2) Establish a medical home using an electronic health record during the first year of the grant for 50% of the school-aged youth who attend Brown and Rowan schools. This percentage will increase by 10% each grant year .3) Develop and expand the clinical practice sites to provide structured learning experiences for 80% of the undergraduate and graduate nursing students for 30% of their clinical experience in a medically underserved, and economically disadvantaged population. 4).Create a model for nurse managed school based medical homes that can be replicated throughout the nation. 5). Document and evaluate the effectiveness of the model to: a) increase access to primary health care services provided in a nurse managed center; b).provide a medical home for school aged children; c) to provide structured clinical experiences for nursing students; and d) potentially be replicated throughout the United States. This program is a unique affiliation amongst the UMSON, JPSD, North Midtown Community Development Center (NMCDC) and Mississippi Baptist Health Systems, Inc. The NMCs will link with UNACARE, the UMCSON’s first family faculty practice site. Targeted Clients are minority children from economically disadvantaged backgrounds enrolled in (2) inner city Jackson Public schools. Recruitment, marketing, enrollment and site development will be in place so that the NMC will be fully operational in August 2008.This program is supported by doctorally prepared faculty and students and the Delta Health Alliance. Proposed total project grant clients served (PY1- 5) — 41,990. The goal is to effectively and efficiently provide quality preventive and episodic acute care to the youth in the Mid-Jackson area in an effort to ameliorate the health problems plaguing the children of Mississippi.

Missouri

Grant Number: D11HP09563-01
Project Title: Post-Master’s Certificate in Child/Family Mental Health
Applicant Organization: The Curators of the University of Missouri
Address: S407 Sinclair School of Nursing, Columbia, MO 65211
Project Director: Jane E. Bostick, PhD, APRN, BC
Phone: (573) 882-0255
Fax: (573) 884-4544
Project Period: July 1, 2008 — June 30, 2011

PURPOSE E3: Providing nursing education in new technologies, including distance-learning methodologies. Experts in a variety of disciplines have called attention to the large numbers of children not receiving the mental health services they need. The Child Health Care Crisis Relief Act (H.R. 2073) estimates that 1/5 of the nation’s children have a mental disorder; however, only 1/3 of these children receive professional mental health care (2007). Children living in rural communities are especially vulnerable due to a shortage of healthcare providers. Because of the major shortage of child and adolescent psychiatrists in the United States today, children suffering from mental disorders are relying on primary care providers and schools to provide most of the mental health services children receive. Child/family mental health nurses are needed to fill this void. A recent Bureau of Health Professions (2006) survey of registered nurses reported that only 5% of advanced practice nurses were nationally certified in psychiatric/mental health nursing in March 2004. In Missouri, only 27 advance practice nurses have advanced practice certification in child/family mental health nursing.

The purpose of this project is to add a distance mediated Post-Master’s Certificate in Child/Family Mental Health nursing to the MU Sinclair School of Nursing (MUSSON) graduate program. A significant barrier to providing advanced educational programs is the geographic location of potential students. Many students are unable to relocate to take the necessary courses for certification, therefore, distance mediated education is a necessity for those wishing to pursue advanced education. A particular strength of this proposal is that students who take distance mediated courses from MU are not charged out-of-state tuition, making distance learning very affordable for potential students. A unique collaboration to share course offerings and faculty resources with the Educational, School and Counseling Psychology department within the MU College of Education is proposed. This innovative partnership will promote collegial relationships among mental health nurse practitioners in community mental health centers and school psychologists in school-based clinics to better serve the mental health needs of children and their families. The proposed curriculum includes 19 credit hours of child/family mental health specialty courses which includes 570 contact hours of supervised clinical practicum (Theory = 58%; Clinical=42%). The MUSSON faculty has been teaching Internet courses since 2000 and are recognized leaders in distance mediated education across the MU campus. This project offers a creative approach to meet the needs of Missouri residents who suffer from the effects of serious mental disorders. In addition, linkages and partnerships with national, state, and local entities will foster a unique alliance among nurse practitioners and school psychologists around the nation.

Nevada

Grant Number: D11HP09567-01
Project Title: Collaborative Approach to Expanding RN to BSN Education
Applicant Organization: University of Nevada Las Vegas School of Nursing
Address: 4505 S. Maryland Pkwy, Box 453018, Las Vegas, Nevada 89154-3018
Project Director: Patricia Smyer, DNSc, RN
Phone: 702-895-5952
Fax: 702-895-4807
Project Period: July 1, 2008 — June 30, 2011

This grant proposal is for consideration under the Nurse Education, Practice and Retention (NEPR), Title VIII, Section 831, Education Priority Area El, Expanding Enrollment in Baccalaureate Nursing Programs. The purpose of this project is to expand enrollment of RN to BSN students through collaboration between the University of Nevada, Las Vegas and Nevada State College. This innovative project, through joint delivery of RN to BSN curriculum, builds on each institution’s strengths, utilizes resources efficiently during the nursing faculty shortage, and expands access for students in the state to pursue a BSN through distance ed ucation technology. The participation of 5 professional nursing organizations, to include the Nevada Organization of Nurse Leaders (NONL), embeds recruiters, leadership mentors and advocates within the facilities targeted for recruitment of RN to BSN students.

Nevada, particularly Las Vegas, has a reputation for excess, including gambling and prostitution, which translates to very real health care problems and issues for the state. While millions of dollars flow into (and out of) the casino industry, many workers and citizens of Nevada do not see the benefit of this when it comes to health care. Since 1990, Nevada has experienced the fastest growing increase in population in the nation at 74.1% due mainly to in-migration. Because of accelerated growth, the capacity to meet the demands for healthcare in urban and frontier areas of Nevada as well as effectively treating the 42 million annual visitors has diminished. Nevada has the second highest nursing shortage in the nation. The acute care demand on emergency rooms, hospitals, and mental health facilities presents a challenge to the already overburdened health infrastructure. In Nevada, the Hispanic population increased by 220.1% and Asian population increased by 205.2%. Approximately 15.8% of the population is foreign born and 23.1% speak a language other then English at home.

According to the American Association of Colleges of Nursing (AACN), Research and Data Center, there were only 23 RN to Baccalaureate completion graduates in Nevada between 8/1/05 to 7/13/06 (2007). Nevada has only 37% of RN’s prepared at this level and only 22% of nurses working in frontier areas are baccalaureate prepared. A better educated nursing workforce will contribute to the academic maturation of Nevada’s nursing profession and professional leadership while improving health care and reducing health disparities. In summary, the need for the project is grounded in three interacting factors affecting Nevada’s capacity to respond to the health needs of its citizens: the compelling demand for nurses leaders prepared at the baccalaureate level to meet these health care challenges, complex health care needs of the citizens of Nevada, and a rapidly growing underserved racial and ethnic minority population. Abbreviated main objectives are to: 1) Increase enrollment in the RN to B SN program by 60 students through implementation of a collaborative distance education program, 2) Recruit minority and underrepresented groups to the collaboration with 30% of admission class from underrepresented groups in the nursing workforce, and 3) Integrate cultural competency components throughout the RN to BSN curriculum.

New Jersey

Grant Number: D11HP05199-04
Project Title: Preparing & Sharing Online Minority Nurse Educators
Applicant Organization: Thomas Edison State College
Address: 101 W. State Street, Trenton, NJ 08608
Project Director: Susan M. O’Brien, Ed.D., RN
Phone:  609-633-6460, Ext 3270
Fax:  609-292-8279
Project Period: July 1, 2008 — June 30, 2011

Thomas Edison State College is seeking a continuation of funding for grant # D11HP05199-03-00, “Preparing & Sharing Online Minority Nurse Educators” for NEPR purpose E3: Providing nursing education in new technologies, including distance-learning methodologies.

Minority representation among nursing faculty is only 10% nationally (AACN, 2006) while student minority representation is 24% (AACN, 2007). Thomas Edison State College proposes a three year continuation of a plan to equip 15 experienced minority nursing faculty per year with online pedagogical skills by means of a revised, 20 week Certificate in Distance Education Program (CDEP). These skills will be utilized in a precepted practicum at the College, and then taken back to the home institution to be shared with colleagues there. In addition, the practicum will serve to increase the College’s own diversity in the nursing faculty. The newly acquired skills will afford these educators the opportunity to reach a greater number of nursing students without restraint of geography by teaching online on a part-time basis at other institutions lacking a diversified faculty presence, thereby increasing the availability of a scarce nursing resource. It may also encourage retired nurse faculty to extend their academic careers, thereby partially alleviating the nursing faculty shortage.

To promote collaboration and networking, an annual Distinguished Lectureship on Cultural Diversity is advertised and hosted by the College, and a directory of qualified online minority educators will be disseminated upon request with Distinguished Lectureship promotional mailings, the Thomas Edison State College Website and via email. Proceeds from this conference will be utilized to continue the program when the period of grant support ends.

It is anticipated that some of the project participants will elect to become part of Thomas Edison State College’s faculty pool at the end of their practicum experience. In this role, working with the Diversity Coordinator, they will be offered the opportunity to collaborate in the development of diversity-related electives to be offered college-wide, bringing tuition income to the School of Nursing, to further support the diversity work.

Formative and summative evaluations will be conducted on the CDEP, practicum experience, and Distinguished Lectureship. A yearly survey of participants will be conducted to track the participants’ involvement in online nursing education, thereby measuring the impact of the Minority Nurse Educator (MNE) Program. A final project report will be written and used as a basis for presentation at national nursing conferences, submitted for publication in professional nursing journals, and published in College publications.

New York

Grant Number: D11HP09758-01
Project Title: Integration of Evidence Based Practice into Problem Based Learning Case Scenarios via Innovative Technologies
Applicant Organization: Stony Brook University School of Nursing
Address: Stony Brook University, School of Nursing, HSC Level 2, Room 199, Stony Brook, NY 11974-8240
Project Director: Marijean Buhse
Phone: 631-444-3284
Fax: 631-444-3136
Project Period: July 1, 2008 — June 30, 2011

The purpose of the project is to incorporate innovative approaches in the use of new technologies to enhance nursing education through the design and implementation of a unique educational model. This model will facilitate the development of critical appraisal necessary for improving the quality of patient care. The model is composed of innovations in both educational methodology and distance learning technology that incorporates: 1) integration of evidence based practice with problem based learning methodologies; 2) threading of these learning methodologies through nursing education program curricula 3) utilization of a web-based distance education platform to support interactive video case studies, faculty led web-based database tours for students and preceptors, and student/faculty group collaboration.

Distance learning technology offers vast opportunities to strengthen the nursing workforce, improve retention and increase the quality of patient care. According to the AACN Issue Bulletin (January, 2000), “distance education helps to counter the nation’s mounting nursing shortage by bringing nursing careers to people who wouldn’t otherwise follow that path because they lack access to a campus, or because work, family, or economic considerations preclude a full-time, on-site education. Distance courses fight “brain drain” from rural areas: students who learn within their own communities are more likely to practice there, and working nurses taking advanced degrees via technology can continue to serve their patients”. It was these benefits of distance learning that inspired the faculty of Stony Brook University School of Nursing in 1993 to embark on the development of a custom written distance learning application developed exclusively for nursing students by nursing faculty. As the development of School’s distance learning program has matured over the past fifteen years, additional technologies have been added to the scope of the distance learning technologies available to the faculty.

This proposal seeks to incorporate an equally innovative approach to nursing education by integrating evidence based practice with problem based learning case studies into the curriculum of the Family and Adult Nurse Practitioner Programs at the Stony Brook University School of Nursing. Students will learn what they need to know to solve the PBL cases by searching for the best evidence using new technologies. These technologies will include the utilization a web-based distance education platform to support video case studies, faculty led web-based database tours, and student/faculty online group collaboration. Clinical preceptors will be able to access a web-based database tour to improve quality of patient care in their own practice.

Promoting evidence based practice (EBP) through problem based learning case studies is an alternative methodology aimed at preparing graduates to be capable of the active, contextual, non-linear, and transformative learning necessary to today’s dynamic clinician. PBL and EBP will be incorporated via web-based video case scenarios that will be added to the current Lotus Notes computer based curriculum delivery system. These cases will unfold over time showing different complex patient problems. Faculty development workshops will be designed to promote understanding of PBL and EBP. Clinical preceptors will have the opportunity to access the web-based database tours and faculty will make some site visits to teach EBP to preceptors.

North Carolina

Grant Number: D11HP09752-01
Project Title: Spiraling Upward for Nurse Retention & Quality Care
Applicant Organization: The University of North Carolina at Chapel Hill
Address: The School of Nursing, 403 Carrington Hall, Campus Box 7460, Chapel Hill, NC 27599-7460
Project Director: Donna S. Havens
Phone: 919-843-1244
Fax: 919-966-7298
Project Period: July 1, 2008 — June 30, 2011

The Purpose: This ground-breaking project will help rural hospitals in underserved counties in PA enhance patient care delivery systems through improving the retention of nurses and the quality of patient care directly related to nursing activities (Purpose R2). The project will benefit rural and underserved populations by stabilizing the nursing workforce which is essential to provide access to quality health care. The project qualifies for statutory funding preference.

The Needs to be Addressed: A robust healthcare work force is essential for an effective health services delivery system. However, an aging population, expanding career opportunities for those who might enter nursing, the advancing age of the majority of nurses, a smaller cohort of younger nurses, poor work cultures, and an increasing demand for nurses are converging to create a serious unmet need for Registered Nurses in PA and across the nation. Due to the unique nurse recruitment and retention challenges faced by rural hospitals the nursing shortage is of critical concern. Data suggest that the nursing shortage will continue to grow and further threaten access to health care, especially for vulnerable populations in rural/underserved areas.

Proposed Services: We will partner with 5 rural hospitals to build capacity to implement features in the nursing work environment that are associated with attracting and retaining nurses and delivering excellent care. Project objectives are to: (1) improve collaboration and communication among registered nurses and with other members of the health care team, (2) increase registered nurse involvement in decisions about nursing work and patient care, and (3) increase cultural competence, including awareness and respect for multigenerational nurse workforce diversity and sub-culture diversity across nursing work units. “Upward spirals” of positive change will be unleashed through an innovative set of change strategies grounded in positive organizational scholarship, complexity science, and participatory action research. The project is novel because it will highlight those things that are being done well as a foundation for change—rather than dwelling on “what is wrong”. Project strategies include: appreciative inquiry, data collection and feedback (hospital sense-making), positive deviance principles, learning collaboratives, mentoring by American Nurses Credentialing Center magnet hospitals and networking/web-interactions. This work will serve as a model that can be replicated by other hospitals across the nation to improve the retention of Registered Nurses.

Population Groups to be Served: The project will impact 5 hospitals in 5 PA rural counties, 988 RNs who work in the hospitals and 389,386 residents (187,372 residents in Medically Underserved Areas and 81,520 residents in Health Professions Shortage Areas).

Oklahoma

Grant Number: D11HP09569-01
Project Title:  Extending Baccalaureate Nursing Education to South Central Oklahoma
Applicant Organization:  East Central University
Address:  1100 E. 14th Street, Ada, Oklahoma 74820
Project Director: Dr. Anne W. Davis
Phone:  580-559-5434
Fax:  580-559-5785
Project Period: July 1, 2008 — June 30, 2011

The purpose of this project is consistent with Education Purposes (E), Purpose El “Expanding enrollment in baccalaureate nursing programs.” The project will establish a new, permanent generic baccalaureate degree nursing program in Ardmore, OK, at the Ardmore Higher Education Center (AHEC). The AHEC, located in Ardmore, OK, is 70 miles southeast of East Central University’s (ECU) home campus in Ada, A second purpose of the program is to increase the number of students enrolled in the RN-to-BSN completion option offered by ECU. An additional project objective is the formation of a partnership with a predominantly Native American kindergarten-l2th grade school in a rural community. The primary need addressed by this project is the is the shortage of registered nurses, particularly baccalaureate registered nurses in a rural, under served, and economically disadvantaged region of Oklahoma. The project will also address the need to increase the level of cultural sensitivity among all nurses who graduate from the program. The principle service proposed is the delivery of high quality baccalaureate nursing education. The population served will be from a rural area with a population density ranging between nine and 55 persons per square mile. Although Carter county, where the new program will be located, is not a federally designated Medically Under Served Area, all but one of the six adjoining counties in the service area of the program, are so designated. American Indians comprise approximately 15% of the population of ECU’s service area. The large number of American Indians who live in the area are over represented in chronic diseases such as diabetes, obesity and alcoholism. The nursing program at ECU has averaged 27% American Indian student enrollment for the past 10 years. Federal grant monies will be used to assist with the funding for the fist three years’ startup costs of the project. After the grant expires, East Central University will assume all costs related to the continuation of the program. Federal monies will be used in equipping one of two skills laboratories in the Ardmore area. Federal monies are also requested to assist in funding a full time faculty position, the RN-to-B SN coordinator, who will oversee all aspects of the option. Funding of this project will allow the RN to BSN option to be converted to a primarily on-line format and offered on an annual cycle, thus doubling the enrollment. Federal monies will also be used to fund a Clinical Coordinator who will be a full time nursing faculty with reassigned time to direct and monitor the additional clinical rotations resulting from the increase in nursing student enrollment. The increase in faculty numbers will require additional faculty office space. ECU is partnering with the AHEC, Mercy Memorial Hospital and the Southern Oklahoma Memorial Foundation to help implement this project. These partners have committed significant monies to fund the costs for a Program Coordinator, two new ITV classrooms, one skills laboratory, three faculty offices, one computer laboratory and the remodeling of a building near the Ardmore hospital to accommodate the students for the expanded program. The President of ECU has made a firm commitment to continuing the program in Ardmore after the three year grant expires.

Grant Number: D11HP09755-01
Project Title: Use of an Open-Source EHR for Nursing Education in Informatics
Applicant Organization: The University of Oklahoma Health Sciences Center
Address: P0 Box 26901, Oklahoma City, Oklahoma 73190
Project Director: Gary L. Loving, PhD
Phone: 405-271-2428
Fax: 405-27 1-1224
Project Period: July 1, 2008 — June 30, 2011

The proposed project is directed towards purpose E3, providing education in the area of new technologies, including distance learning methodologies. Specifically, the project purpose is to integrate selected health care informatics competencies into a baccalaureate nursing education curriculum. The University of Oklahoma College of Nursing (OUCN) will acquire a clinical information system (CIS) developed in the public domain, OpenVista. Vista was developed initially for use in Veterans Affairs (VA) health care facilities.

Project Staff will develop a Web Portal for remote access to the CIS. OUCN has students in a variety of locations in Oklahoma and other states. Project faculty will develop simulated data sets and other experiential learning activities in OpenVista for use in clinical courses across the baccalaureate curriculum. Students will practice documenting and retrieving simulated and deidentified data using an actual electronic clinical information system. Nursing project faculty and staff will collaborate with faculty and staff from the Medical Informatics Department at the University of Oklahoma-Tulsa Schusterman Center on the development and implementation of clinical data sets to be used within the OpenVista CIS. Faculty at OU-Tulsa will also pilot the use of existing data sets in GE Centricity, an ambulatory care CIS used by OU Physicians.

Student and faculty training materials for use of the CIS will be developed and implemented. A consultant who is expert in nursing informatics will conduct annual faculty development workshops on informatics topics. During year 03 of the project, these workshops will also be open to other member schools of the Institute for Oklahoma Nursing Education. The proposed project is directed towards BHPr Goal 3, “Assure Quality of Care: Improve the knowledge, skills, competencies and outcomes of health professions workforce.”

A few university-based nursing schools have initiated academic applications of commercial clinical information systems to teach students informatics competencies. These commercial solutions are prohibitively expensive for most schools. To our knowledge, no nursing school has previously utilized a CIS developed in the Public Domain. OpenVista is significantly less expensive than commercial solutions. For this reason, it has recently been adopted by a number of small- to medium-sized healthcare facilities who cannot afford the more expensive commercial solutions. With further development for use in academic settings, OpenVista has the potential to be a cost-effective solution to preparing health professions students for practice in twenty-first century, technology-rich healthcare environments.

Texas

Grant Number: D11HP05196-04
Project Title: Ministerio de Salud - A Community Partnership for Health
Applicant Organization: University of the Incarnate Word
Address: 4301 Broadway, CPO #300 San Antonio, Texas 78209
Project Director: Sara E. Kolb, RN, Ph.D.
Phone: (210) 829-3163
Fax: (210) 829-3174
Project Period: July 1, 2008 — June 30, 2011

This competing continuation NEPR project addresses Purpose (P2): Providing care for underserved populations and other high risk groups. The focus of the project is to increase access to quality health care for economically disadvantaged, elderly Hispanic residents in San Antonio, Texas. To address this need, the School of Nursing and Health Professions at the University of the Incarnate Word (UIW) seeks to expand a community partnership for health with St. Philip of Jesus Catholic Parish (SPJ) located in an economically-distressed, predominantly Hispanic neighborhood (zip code 78204) just south of downtown San Antonio. While the Partnership office is physically located in zip code 78204, health services are available to any resident who needs them.

Hispanics are the largest minority population in the United States. In San Antonio, they account for a vast majority of city residents, comprising 61% of the total population (American Community Survey, 2006). In zip code 78204, they make up 92% of residents.

Needs of the Hispanic elders identified through the implementation of the first NEPR award are related to geographic, health, economic and other demographic factors. Low health literacy combined with problems accessing primary health care services result in worsening health disparities for this population. Furthermore, the San Antonio Metropolitan Health District (2005) has identified zip code 78204 and surrounding communities as one of the most vulnerable in San Antonio in the event of a disaster due to the number of disabled elderly and low-income residents.

The focus of this project is to enhance a Service-Learning based curriculum focused on providing culturally and linguistically appropriate health care for Hispanic elders. Courses are specifically in place that provide opportunities for UIW nursing students, faculty, and community members to work together to increase access to health promotion and disease management services for vulnerable community-residing Hispanic elders. This will result in an increased number of nurses skilled in the delivery of culturally and linguistically appropriate health care for this growing population.

The proposed project which combines several models of community-based health enhancement will be operational by July 1. 2008. Components include use of a service- based focus, combining Parish/Faith Community Nursing and community lay health workers (Promotoras), and a nursing model of Community Partnership Primary Health Care. Logic modeling provides a comprehensive method of charting both formative and summative evaluations, and is used as a visual representation of measurement methods.

Statutory Funding Preference for projects that substantially benefit underserved populations is requested.

Grant Number: D11HP09566-01
Project Title: Academic Collaboration and Caring for Educational Success and Service (ACCESS)
Applicant Organization: Lamar University
Address: JoAnne Gay Dishman Department of Nursing P. 0. Box 10081, Beaumont, TX 77710
Project Director: Eileen Deges Curl, PhD, RN and Sandy Brannan, ABD, RN
Phone: 409.880.8817
Fax: 409.880.1865
Project Period: July 1, 2008 — June 30, 2011

Increasing the number of baccalaureate prepared nurses through a career ladder advancement program (grant purpose R1) and promoting public health safety and homeland security by preparing a nurse workforce knowledgeable about disaster preparedness are the main purposes of the Academic Collaboration and caring for Educational Success and Service (ACCESS) project. Through the ACCESS project, licensed vocational/practical nurses (LVNs) and registered nurses (RNs) with associate degrees in nursing will attain Bachelor of Science in Nursing (B SN) degrees through the partnership of four higher education institutions in Southeast Texas. The project provides a seamless education initiative compatible with the needs of adult learners and working nurses. Innovative distance education instructional strategies like interactive Internet conferencing, electronic peer learning communities and a Virtual Caring Place to facilitate learning will promote nurses’ academic success. The unique feature of the project is providing needed disaster education to over 500 rural and/or medically underserved individuals with disabilities or special needs in five counties in Texas.

The acuity of Texas’ nurse shortage is higher than other states in the nation because the population growth in Texas continues to increase more rapidly than in other states (Texas Center for Nursing Workforce Studies, 2006). Additionally, Southeast Texas needs a nurse workforce prepared to respond and recover from natural and man-made disasters because of high risk factors in the region. Located along the Gulf of Mexico, Southeast Texas is geographically susceptible to hurricanes. Two other risk factors include a) massive petroleum refineries in the region that supply a significant portion of the gas for the nation, and b) Port of Beaumont, the fourth busiest port in the nation and a major transport site for deployment of military equipment. These factors make the region a major target for terrorism and at high risk for explosions or chemical hazards.

Lamar University (LU), Lee College, Lamar State College Orange and Lamar State College Port Arthur will address these needs by partnering to increase the number of BSN prepared RNs (N = 112) with expertise in disaster preparedness, response and recovery for rural and medically underserved populations. Beaumont Public Health Department will be a key partner with the disaster component of the project. Distance education technology and ACCESS Sites in Southeast Texas will provide a seamless transition to LU’s RN to BSN program. BSN courses will be available online with video streaming of lectures and podcasts for easy download to computer or media devices for perusal at students’ convenience while juggling work and family responsibilities. Interactive conferencing at ACCESS Outreach Sites will be used for mentoring and counseling.

Grant Number: D11HP09754-01
Project Title: Using Digital Technology to Learn, Instruct, and Communicate
Applicant Organization: The University of Texas Health Science Center at Houston
Address: 6901 Bertner Ave., Room 695 Houston, TX 77030
Project Director: Renae R. Schumann, PhD, RN
Phone: 713-500-2163
Fax: 713-500-2171
Project Period: July 1, 2008 — June 30, 2011

The project supports Purpose E3, providing education in the area of new technologies, where the devices selected are commonly used electronic, digital devices and the intent is to repurpose their basic use in learning, teaching and communicating in healthcare. To do this, courseware will be developed that promotes technical facility and information literacy. The courseware focus on fundamentals to nursing informatics, is competency-based, and is presented in a game format. Participants earn points as they progress through the program which can be traded for objects (books, scrubs, etc.) useful in their training or practice. The players are culturally diverse samples of BSN students enrolled in BSN programs at The University of Texas at Brownsville, a predominately Hispanic population, and The University of Texas Health Science Center at Houston (UTHSC-H), whose student population is predominately white and African-American. The purpose is for students to learn fundamentals principles and techniques that will permit them to access, verify, organize, manage, and present data either for learning or teaching activities. Although students are expected to have one or more of the prevalent digital electronic devices, study participants will be issued a Personal Digital Assistant (PDA) to use for the duration of the project.

The study sample contains both pre-licensed and licensed nurses. At each school, 10 students will be randomly selected from RN to BSN incoming classes per academic year for a total of 60 participants. For nurses wanting continuing education credits, 9.3 CEUs are awarded at program completion. Adding to the sample will be 10 students per enrolling class of the generic baccalaureate program at UTHSC-H for a total of 50 students. These pre-licensed students will participate in both the technology program and a technology application designed to minimize a major obstacle to using a preceptor model as an alternative to increasing capacity. That precepting works and that students and nurse preceptors are highly in favor of the program has been established by the Program Director and her team in three previous projects. This proposal is a next step toward increasing the supply of nurses trained to provide quality care. The intent is to develop health care plan that students can complete online and will reduce faculty time on task to assess health care plans by 50%.

The expected outcomes are that given a pre and post test, students will show a significant increase in information literacy and given a standardized health assessment test, students in the experimental group will show a significant gain over students in a traditional (control) setting. Whereas an online health care plan is expected to aid in building capacity, the information literacy program is expected to aid in student retention. Based on the need for this course and the positive reaction of students, faculty, and local hospital administrators to its inception, the course modules will be opened to the student population at large in Year 3 of the project. This will aid in sustaining the program over time as will future accreditation requirements will include use of emergent technologies -- for which this program is a start.

Grant Number: D11HP09757-01
Project Title: Culturally Competent Nurses In Community Health
Applicant Organization: University of Texas Medical Branch
Address: 301 University Blvd., Galveston, Texas 77555-1029
Project Director: Elizabeth Reifsnider, PhD
Phone: 409-772-8262
Fax: 409-747-1554
Project Period: July 1, 2008 — June 30, 2011

This project meets Purpose P4, Developing cultural competencies among nurses. Improving the health of underserved populations and reducing health disparities among disadvantaged populations require that nurses understand the cultural issues that underlie the health behaviors of these populations. The mission of the “Preparing Culturally Competent Nurses in Community Health” (CCNCH) is to provide enhanced education to practicing nurses on using cultural competency in their practice to improve health in underserved populations. The second goal of Healthy People 2010 is to eliminate health disparities among diverse areas of the population. This priority can be directly addressed by increasing the cultural competency of nurses working with underserved populations.

The purpose of CCNCH is to create a statewide resource for improving cultural competency for nurses in Texas through development and implementation of a comprehensive evidence-based curriculum on culturally competent nursing care, delivered through online modules. This project focuses on Purpose P4, Develop Cultural Competencies among Nurses, and requests statutory funding preference as it will help to meet nursing needs in state and local public health departments, acute care and long term care, and community-based settings.

The project is aimed toward registered nurses (RN) in rural and urban health departments, hospitals, community clinics in Southeast Texas, and baccalaureate nursing students at UTMB. The Program Goal is to: Assure Quality of Care by improving registered nurses’ competencies in applying knowledge of cultural beliefs, skill in providing nursing care that is culturally acceptable to the client, and improving the outcomes of nursing care that are impacted by cultural practices of the client. The Program Objectives are to (1) develop and provide a modular online program in culturally competent nursing care that can be delivered to undergraduate students in existing courses and to registered nurses practicing in long-term care, acute care, or community-based settings (National Goal 1) (HP 2010); and (2) develop and provide a program to enhance the leadership skills of registered nurses in the practice of cultural competence with individuals and families in long-term care, acute care, or community-based settings (National Goal 1) (HP 2010).

This project will be offered to all nurses in the University of Texas Medical Branch Hospitals and Clinics, the public health nurses in Galveston, Harris, Brazoria County Health Departments, the City of Houston Health Department, and the San Antonio Metropolitan Health District. Through partnerships with all the Area Health Education Centers in Texas, RNs in rural communities will also be offered the culturally competent program. At least 210 registered nurses and 600 nursing students will receive continuing education on cultural competence through this program.

West Virginia

Grant Number: D11HP09553-01
Project Title: Competency-based Orientation for Retention Enhancement in ICU
Applicant Organization: West Virginia University
Address: WVU School of Nursing, 7600 HSC-South, P0 Box 9600, Morgantown, WV 26506
Project Director: Georgia L. Narsavage, PhD, CRNP, FAAN
Phone: (304) 293-6521
Fax: (304) 293-6826
Organizational Website Address: http://www.wvu.edu/ and http://www.health.wvu.edu/
Project Period: 07/01/2008 – 06/30/2011

This proposal addresses Purpose R2 to improve the recruitment and retention of registered nurses in critical caret and thus enhance patient care that is directly related to nursing activities in the ICU. This will be realized by enhancing collaboration/ communication among registered nurses and other health care professionals during the orientation process, with a program focused on level of competency matched to orientation level, promoting nurse involvement in the organizational and clinical decision-making processes of the orientation. Competency-based Orientation for Retention Enhancement in ICU (CORE-ICU) will be a dynamic entity to increase recruitment and enhance retention through a learner-centered, cost-effective orientation to improve care for critically ill patients. As program partners, West Virginia University (WVU) School of Nursing (SON) with West Virginia University Hospital (WVUH) and WV United Health Systems will meet the challenge of transitioning staff nurses/new graduates to 21st century critical care by nurse competency (knowledge, skill and attitudes; KSA5) aligned to levels of orientation. RN vacancies in CORE-ICU units increased over 30% in 2007 due to rapid expansion based on need for critical care. A Competency-based Orientation program will orient at least 100 qualified Critical-Care RNs in less than 3 years, improve retention and enhance patient care. Objectives: 1) Develop and implement a 5-level Competency-based Orientation program for Critical-Care nursing using Knowledge (BKAT) - Skill (SimMan) - Attitude (Critical Thinking) testing, incorporating collaboration among RNs and other health professionals to prepare a diverse RN workforce to deliver culturally competent care (IACCP-R) that benefits WV’s urban, rural, underserved people (National Goal 3). 2) Increase number of nurses practicing in critical care as evidenced by improved retention and decreased vacancy rates (National Goal I). 3) Improve patient care as evidenced by decreased ICU sentinel events: Ventilator associated pneumonia, urinary track infections, and blood stream infections, and increased nurse satisfaction (Healthy People 2010). 4) Evaluate/ disseminate a “best- practices” Competency-based Orientation program, CORE-ICU for Critical-Care nursing, using Knowledge- Skill-Attitude testing by levels to cost-effectively prepare and retain specialty nurses. WVU SON’s experienced faculty teamed with dedicated WVUH nursing, physician and allied health staff, in an academic medical center where RNs care for underprivileged patients with complex needs, plus 30 hours in high tech simulation labs to build CCRN skills make an exceptional combination. This Competency-based Orientation plan assigns Critical Care Nurse Mentors by orientee’s level of competence with significant effort in mentor preparation, assessment of competencies at entry to program and readiness for orientation completion. Graduated leveling by competencies supports completion of the CORE-ICU program; Committed preceptor educators/RN mentors assure sustainability. Measured outcomes include halving vacancy and attrition rates; plus values and other measures of clinical and cultural competency, nurse-satisfaction; and tracking of sentinel events (HP2O1O). Finally, a best-practices video for developing orientation programs, along with publications, and presentations will disseminate our outcomes.