Using innovative models in transition to practice and Master's Entry programs to teach ambulatory and primary care nursing.

With advancements in health care and changes in reimbursement that contribute to shorter hospitalizations, health care delivery is increasingly shifting to other settings to include skilled nursing, home care, and outpatient areas. There is a well-documented shortage of hospital-based capacity for clinical placements in California. The need for clinical placements is creating an opportunity to utilize ambulatory care settings as innovative alternative learning experiences for prelicensure nursing students. Care coordination, health coaching, and population health management are examples of skills useful for all RNs that ambulatory care settings offer as learning experiences for nursing students. The skills and knowledge students gain in ambulatory care are valuable for a wide range of employment settings. Additionally, these alternative settings provide faculty other clinical placement options since acute care placements are difficult to secure and sustain. The University of San Francisco (USF), School of Nursing and Health Professions (SONHP) developed two educational models to prepare nurses for complex disease management. One was a post-graduate new RN program that focused on outpatient/ambulatory care, the Transition to Practice Program (TTP). The other was a prelicensure Master's-Entry Master's of Science in Nursing (ME-MSN) program that has an ambulatory and acute care pathway.

Clinical Training Innovation for Prelicensure Graduate Nursing Students to Expand Roles in Primary Care.

BACKGROUND: With the aging population, the prevalence of chronic disease is increasing, requiring a team-based approach to care with registered nurses (RNs) playing a vital role. PROBLEM: Nursing education generally prioritizes acute care rather than ambulatory care; however, nursing students should also be prepared to adequately respond to the population needs for longitudinal chronic care management. APPROACH: To address the need for RNs to assume a role in chronic care management, a School of Nursing and Health Professions piloted a clinical option in which second-degree master of science in nursing students are prepared to function as health coaches on primary care teams at a local community health center. CONCLUSIONS: Reshifting the focus of nursing education to integrate primary care nursing, it is important to embed nursing students into primary care practices where they can learn about the longitudinal care of patients with chronic conditions.