Implementation of a Registered Nurse Primary Care Clinical Mentoring Academy.

Registered nurses (RNs) are pivotal team members for improving the quality of care in communities; however, they are underutilized in primary care. Two schools of nursing in Alabama partnered to develop and implement a project to build a resilient primary care RN workforce. A major component of this project is the Primary Care Clinical Mentoring Academy (PCCMA), which was designed to prepare RN clinical mentors to implement positive student learning experiences in the primary care setting. The PCCMA follows a comprehensive curriculum implementing both didactic instruction and interactive activities related to primary care competencies; interprofessional education and collaborative practice; and primary care RN mentor roles and responsibilities. Participants reported that the PCCMA was effective and useful, and they perceived that it would improve their overall job performance as a clinical mentor. The PCCMA is an effective way to produce confident and capable RN mentors in primary care. [J Contin Educ Nurs. 2022;53(7):312-320.].

Curricular and Clinical Innovation Engaging Undergraduate Nursing Students to Build a Resilient Primary Care Workforce.

BACKGROUND: Primary care health settings provide access to services for underserved populations, yet baccalaureate (BSN)-prepared nurses are currently underutilized on the primary care health care team. PROBLEM: BSN curricula often focus on acute care settings for clinical experiences, and students may not be aware of the scope and impact the RN has in a primary care setting. This gap in experiences may lead to overlooking primary care employment opportunities. PURPOSE: The purpose of this article is to describe the development, implementation, and evaluation of an innovative course that builds the primary care nurse workforce capacity. APPROACH: An undergraduate elective course focusing on primary care didactic and clinical experiences was created. OUTCOMES: Qualitative student feedback regarding the course was positive, while quantitative data revealed an above-average course outcome rating. CONCLUSIONS: An effective intervention to increase workforce capacity in primary care settings is to immerse students in primary care concepts and experiences in a formal, combined didactic and clinical course.

Improving provider awareness to statin prescribing guidelines: A quality improvement project.

Guidelines recommend statin therapy for all patients with peripheral artery disease (PAD) due to the increased risk of adverse cardiovascular events. A lack of adherence to these guidelines was identified at a vascular clinic located in the southeastern United States. The aim of this nurse practitioner-led quality improvement project was to increase the percentage of patients with lower extremity PAD who were prescribed a statin medication at this clinic. Baseline data were obtained via a chart review. Using the Plan-Do-Study-Act (PDSA) model, a paper tool depicting an evidence-based algorithm was implemented in the clinic for 6 weeks to increase awareness of guidelines (PDSA cycle 1). Next, an electronic pop-up reminder was implemented in the electronic health record for the following 6 weeks (PDSA cycle 2). Data were collected throughout the process and analyzed to determine if either intervention increased the number of patients with PAD who were prescribed a statin medication. Baseline data revealed only 54.16% of patients were on a statin medication. After PDSA cycle 1, an average of 70.8% of patients were on a statin medication. PDSA cycle 2 revealed an average of 73.3% of patients were taking a statin medication. ANOVA was conducted and showed statistical significance between the groups (P = .003). There was statistical significance between baseline and implementation of the algorithm and baseline and implementation of the pop-up, but not between the 2 interventions. These findings are consistent with research suggesting algorithms and electronic reminders may increase medical staff awareness of guidelines. Standardization of these interventions enhanced provider adherence to guidelines and ultimately improved patient outcomes.

New Osteoporosis Treatment Means New Bone Formation.

The U.S. Food and Drug Administration approved romosozumab as a new osteoporosis drug in April 2019. Marketed under the brand name Evenity (Amgen, Thousand Oaks, CA), it is a sclerostin inhibitor that promotes new bone formation. It is the first in its drug class to work by increasing bone formation and also preventing bone resorption. It has been approved for use in postmenopausal women at greater risk for bone fracture. Romosozumab is administered once monthly in injection form for 12 consecutive months.