Advancing the Role of Post Baccalaureate Nurse Graduates in Interprofessional Team-Based Primary Care

Friday, March 27, 2020

Marie Therese Timbol-Padriga, MSN, RN
Nursing Education, VA Puget Sound Health Care Systema, Renton, WA, USA
Anne P. Poppe, PhD, BA, RN
Patient Care Services, VA Puget Sound Health Care System; University of Washington School of Nursing, VA Puget Sound Health Care System, Lake Stevens, WA, USA

Purpose: Academia alone cannot adequately prepare nurses for challenges of the ever-changing health care system, increasing patient acuity, and advancements in the technological environment. An increase of 42.3% in the nursing workforce is needed to address the anticipated nursing shortage due to new nurses leaving the profession within the first year post graduation and to retirement. The goal of this innovative post baccalaureate nurse residency (PBNR) program is to help new Bachelors in Nursing (BSN) graduates transition successfully to their first nursing role to meet the future needs of health care in the ambulatory care setting. The purpose of the VA Puget Sound Health Care System PBNR is to promote the advanced education of new BSN graduates in delivering patient-centered care as part of interprofessional teams, thereby creating clinical leaders who can transform healthcare services, and improve health outcomes.

Methods: The PBNR program uses the Knowledge to Action (K2A) Process framework that clarifies key elements that facilitate the use of empirical knowledge within the clinical context. The Knowledge to Action cycle has identified milestones that bridge the knowledge to action gap. Within this framework, the BSN-RN resident in the PBNR program will learn in a mentored environment to apply the best available evidence/knowledge through effective educational strategies. Systematic continuous evaluation is incorporated as part of the process to facilitate knowledge translation from classroom to practice. The PBNR is designed to expand the innovative interprofessional Patient Aligned Care Team (PACT) learning community to include an RN care manager as their primary preceptor on a teamlet, which consists also of their NP or MD primary care provider (PCP); LPN or health technician; pharmacist; psychologist; and clerical support staff. The residency program is focused on shared decision making, promotion of sustained relationships with patients through longitudinal care, and building effective interprofessional PACTs. Strong communication skills represent the underpinning for each of the areas of focus. The interprofessional Education Collaborative core competencies guide the core curriculum in the following areas:

  • Values/ Ethics for interprofessional practice
  • Roles/ Responsibilities
  • Interprofessional Communication
  • Teams and Teamwork

Results: The PBNR program is recruiting for the pilot cohort for academic year 2019-2020. Literature demonstrates that newly graduated nurses benefit from additional training to master thier clinical skills. Data will be collected and analyzed to determine trainee engagement in interprofessional team based care and whether the advancement of new BSN graduates meet the transformative challenges of primary care. The PBNR program will evaluate BSN residents in their clinical skills competencies and the dimensions of interprofessional teams. Program evaluations will also include resident demographics, confidence in practice, trainee satisfaction, trainee career choice, and subsequent effects of team based practice on outcomes.

Conclusion: The PBNR program will provide a mentored and supervised transition of newly graduated BSN nurses for safe and competent clinical practice in an academic residency model. Results from the inaugural cohort will inform curriculum and program enhancements using a continuous quality improvement process. If successful, this model program can be a strategy to support recruitment and retention of the future nursing workforce.