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Collaborating with Rural Practice Partners to Address
the Need for Registered Nurses in Primary Care
Robin Brown, PhD, RN; Heidi Mennenga, PhD, RN, CNE; Alham Abuatiq, PhD, RN; Linda Burdette, PhD, RN;
Leann Horsley, PhD, RN, CHSE, CNE; Christina Plemmons, PhD, RN-BC, CNE
College of Nursing
INTRODUCTION METHODS IMPLICATIONS
Primary care in the US is changing. • 13 rural practice partners located across South Dakota • Use of a needs assessment may help
and bordering Minnesota towns academic partners obtain valuable
• Growing shortage of healthcare providers information about potential clinical practice
(AAMC, 2018). • Asked to complete a needs assessment focused on the sites.
• Increased prevalence of chronic disease current and future use of RNs practicing to the full scope
(AAMC,2018). of their license in primary care • Results from a needs assessment may
enhance the academic-practice partnership
• RNs are underutilized in primary care between the primary care facility and the
setting (Bodenheimer & Bauer, 2016). academic institution.
• RNs not practicing to full scope of their • Results from needs assessment will be
license in primary care (Flinter et al., 2017).
used to develop innovative strategies to
fully utilize RNs in primary care settings in
Primary care practices need to redesign their collaboration with rural practice partners.
delivery models to fully utilize the skills and
expertise of RNs (Josiah Macy Jr. Foundation, • Strategies may enhance care and improve
2016). RESULTS patient outcomes in rural and/or
• RNs have shown to be effective chronic underserved primary care settings locally
disease care managers (Bodenheimer & • 12 practice partners completed needs assessment and potentially around the world.
Bauer, 2016). • 10 practice partners utilize RNs in primary care; 8 utilize
LPNs in primary care
• RNs who are practicing to the full scope of • Practice partners expressed high interest in expanded
their license can assist in meeting the use of RNs in primary care
unmet healthcare needs. • 58.3% (n=7) utilize standing orders
• RNs practicing to full scope of license:
• Independent RN visits (n=1) REFERENCES
• Care management (n=3)
• Collaborative provider/RN visits (n=3)
PURPOSE • Association of American Medical College (AAMC). (2018). New
research shows increasing physician shortages in both primary and
specialty care. Retrieved from https://news.aamc.org/press-
Reported level of knowledge Reported confidence in releases/article/workforce_report_shortage_04112018/
about “full scope of the RN applying the “full scope of
The purpose of this project was to collaborate license”: • Bodenheimer T. & Bauer, L. (2016). Rethinking the primary care
with rural primary care practice partners to RN practice”: workforce-An expanded role for nurses. The New England Journal of
address the need for RNs who can practice to Medicine, 375, 1015-1017. doi:10.1056/NEJMp1606869
the full scope of their license in primary care. Self-rated Level of Knowledge Self-rated Confidence • Flinter, M., Hsu, C., Cromp, D., Ladden, M, & Wagner, E. (2017).
8.3% Emerging new roles and contributions to team-based care in high-
16.7% 16.7% performing practices. Journal of Ambulatory Care Manager, 40(4),
Examples of full scope of the RN license include: 16.7% 25.0% 287-296.doi: 10.1097/JAC.0000000000000193.
• Independent RN visits
16.7% • Josiah Macy Jr. Foundation (2016). Registered nurses: Partners in
• Care management 16.7% transforming primary care recommendations from the Macy
• Medication management Foundation Conference on preparing registered nurses for enhanced
roles in primary care. Retrieved from:
• Collaborative provider/RN visits (Flinter et al., 41.7% https://macyfoundation.org/publications/registered-nurses-partners-
2017) 41.7% not confident (n=2) in-transforming-primary-care
novice (n=1) beginner (n=2) somewhat confident (n=2)
competent (n=5) proficient (n=2) confident (n=5)
expert (n=2) very confident (n=3)
This project, entitled Impacting Models of Practice and Clinical Training for Registered Nurses and Students (IMPACT-RNS), is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department
of Health and Human Services (HHS) under grant number UK1HP31729 and title Nurse, Education, Practice, Quality and Retention - Registered Nurses in Primary Care for $2,751,222 and 0% financed with nongovernmental
sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by, HRSA, HSS, or the U.S. Government
The authors would like to acknowledge the members of the project team: Cassy Hultman, Valborg Kvigne, Marie Schmidt, Beth Walstrom.
