Utilizing a HRSA Training Grant to Promote PMHNP Student Resilience: Answering the Call to Enhance Trauma-Informed Teaching and Learning Practices in Nursing Education.

Nursing burnout has reached a new level of prevalence among professionals and is rising among nursing students and can impact student success in the classroom and clinical areas. Among advanced practice nurses, psychiatric-mental health nurse practitioners have the least favorable combination of low compassion satisfaction and high secondary traumatic stress, placing them at even greater risk for burnout compared to other specialties. Trauma informed teaching and learning principles can serve to prevent burnout and have a positive impact on learning outcomes. Through these teaching methods, nurse educators have the opportunity to both support students during their nursing education and prepare students for the professional stressors that contribute to burnout. This quality improvement project involved implementation and evaluation of a HRSA funded program to train PMHNP students interested in working in rural and underserved areas. The training intervention included didactic curricular enhancements, a trauma resiliency training and a longitudinal clinical practicum. Qualitative program outcomes indicated that trainees were implementing trauma-informed principles and skills with patients and for self-care during their nursing training and at one year follow-up. The program may offer practical upstream solutions for nurse educators and future studies should explore concepts more formally to develop best practice models.

Bringing COVID-19 vaccine to medically underserved populations utilizing a community-guided mobile vaccine program.

Between March 23, 2021, and December 31, 2022, the Mobile Vaccine Program (MVP) vaccinated 5044 individuals from medically-underserved communities in Middle Tennessee identified through and guided by a collaboration of local community agencies. The primary objective of the MVP was to vaccinate individuals for COVID-19 who had barriers to traditional mass vaccine strategies through community-guided strategies and partnerships. Three strategies were developed and implemented with community partners and their affiliated community health workers (CHWs). The strategies included pop-up vaccination clinics at community partner events, CHW-guided door-to-door in-home vaccination, and community partner-initiated homebound referrals for vaccination.

Education to Improve Point of Care Documentation in Home Care Nurses: A Quality Improvement Project.

Home care nurses are expected to document their care delivery while in the patients' homes. Point of care documentation ensures that information in the EHR is accurate, timely, and accessible to all care team members. Standard training emphasized the features and functions of the different tabs within the electronic record. Managers and nurses reported standard training was not effective. The purpose of this project was to perform a post-implementation evaluation of the incorporation of point of care documentation, using case study scenarios, into the EHR training to determine if there was improved timeliness of documentation by new home care nurses. Quantitative data showed no statistical difference between the pre-implementation and post-implementation participants on completion of documentation within 24 hours from the small sample groups. Quantitative data from training evaluations showed a positive impact on learners' confidence and willingness to complete point of care documentation. Qualitative results showed participants viewed scenario-based training as interactive, meaningful, and indicative of a change in practice to include point of care documentation in the patients' home. The results suggest continued evaluation of the use of scenario-based education with point of care documentation as a format for more effective EHR training.

Suicide detection and treatment in a nurse-led, interprofessional primary care practice: A 2-year report of quality data.

ABSTRACT: Analysis of 2 years of quality improvement data after the implementation of a suicidality screening and treatment protocol in a primary care setting found that among 1,733 patients, 149 had suicidal ideation. Among the 112 of those patients who remained in care, more than half presented with only nonpsychiatric complaints. Primary care practices may be viable tools to combat the nation's suicide epidemic.

Development of an Interprofessional Home Healthcare Management Service: Within an Urban Housing Development.

In response to the need for increased access to primary care services for a low-income, at-risk community, two local universities partnered with a nonprofit Housing and Urban Development affiliated provider of affordable housing to launch a primary care clinic within an urban public housing community. Although the establishment of this clinic represented progress in meeting many healthcare needs of the target population, an interprofessional team also identified a need for the initiation of a new home-based service line. The goal of this project was to establish an innovative, sustainable, and cost-effective healthcare delivery method that would improve the health of this population. The project focused on a literature review, needs-assessment, and development of a comprehensive medical home visit program to serve the homebound, frail elderly, and other at-risk adults with complex medical conditions who reside in this community. The medical needs of potential recipients were assessed by conducting interviews with key support staff including a health service coordinator, health advocates, and housing provider service coordinators. Residents were also interviewed using a newly developed health perception and information survey. The data derived from the needs-assessment and pertinent literature were used to draft an initial program guideline. Because the needs-assessment indicated this population would not derive maximum benefit from a traditional house calls program, the project team developed a Home Healthcare Management service with an expanded scope to provide enhanced care coordination, house visits (medical and nonmedical), and community outreach.

Integration of Clinical Pharmacist Services into an Underserved Primary Care Clinic Utilizing an Interprofessional Collaborative Practice Model.

This report describes the role of a clinical pharmacist serving onsite in an interprofessional collaborative practice care model at an urban underserved primary care clinic. It also overviews current health care legislative policy as it relates to expanding pharmacists roles as an integrated team member in medically underserved, vulnerable populations.

Evidence-Guided Integration of Interprofessional Collaborative Practice into Nurse Managed Health Centers.

The Division of Nursing, Bureau of Health Workforce, has spearheaded a 3-year effort to increase the skills of nurses to lead interprofessional collaborative practice (IPCP) teams. Since 2012, the Nurse Education, Practice, Quality and Retention program has funded 53 sites engaged in this work. The purposes of this report are to describe the IPCP framework undergirding implementation at one such site, describe the evaluation components and approach, describe how health professions students are integrated into this model, and discuss implications of IPCP for future nurse-managed/nurse-led initiatives within an evolving health care environment. Core team members include a family nurse practitioner, physician, pharmacist, social worker, and community health advocate. The clinic is located within a public housing complex; the target population is largely uninsured or underinsured with a historically high rate of emergency department utilization.

Evidence-based development in nurse-led interprofessional teams.

Team-based care is often described as the best way to provide health care. However the effective use of teams in primary care is not yet prevalent in the US and nurse-led interprofessional collaborative teams are rare. Over the past three years the US Department of Health and Human Services has put great emphasis on the development of nurse-led interprofessional teams and this article describes the development of one such team in a primary care setting and the evidence base behind it.

Potentials of internet-based patient engagement and education programs to reduce hospital readmissions: a spotlight on need in heart failure.

Internet-based applications and mobile health technology has advanced at unprecedented rates over the last decade and has proved to be a highly effective platform for communication. Simultaneously, the United States health care system has reached a critical and unsustainable level of spending, arising largely from ingrained system inefficiencies and overall suboptimum communication. Internet-based and mobile health technology offers an innovative solution to both of these problems. The prevention of readmissions for heart failure provides an excellent example of how this new technology can be used in today's health care environment to improve patient care.