Nurse Education, Practice, Quality and Retention - Workforce Expansion Program - FUNDING PREFERENCE: RURAL This project qualified for funding priority as North Dakota (ND) is substantially rural with all 53 counties designated as fully or partially rural. NEEDS & POPULATION: Between 45-51% of BSN nursing graduates from the University of North Dakota have been licensed to practice in rural counties following graduation from 2019-2023. The leading causes of death among ND residents include heart disease, Alzheimer’s disease, stroke, and chronic lower respiratory disease, highlighting the need to make management of chronic conditions an urgent priority. Health disparities are stark for ND Native American communities when compared to overall state and national averages, with significantly higher mortality rates due to coronary heart disease and stroke, as well as higher rates of Alzheimer’s disease and chronic obstructive pulmonary disease (COPD). To address this challenge of providing quality care to older adults, the 4Ms Framework from the Age-Friendly Health Systems movement will be used to guide this proposal, which keeps the focus on What Matters, Medication, Mentation, and Mobility. A recent registered nurse (RN) workforce analysis highlighted a nursing shortage as compounding these challenges in ND, with the state ranked as one of the five worst states for an anticipated nursing shortage by the year 2030 (Lyons, 2023). This funding proposal aims to help address the challenge of the ND Nursing Workforce Shortage in Acute and Long-Term Care Settings. The population groups served by the proposed work are the Native Elders and Rural Older Adults in Acute or Long-Term Care in ND. OVERVIEW & PURPOSE: The overall purpose of this new proposal is to 1) Strengthen the clinical excellence of undergraduate nursing students to address the complex healthcare needs of Older Adults receiving care in Acute and Long-Term Care settings, including care of Native Elders and Older Adults from Underserved Rural Areas in the Northern Plains; 2) Increase the admission and retention of undergraduate students from disadvantaged backgrounds; 3) Empower nursing students from underserved rural areas or disadvantaged backgrounds through mentoring to successfully complete the Bachelor of Science in Nursing (BSN) degree; 4) Transform the nursing workforce through the facilitation of recruitment and employment of nurse preceptors and clinical instructors to guide students the provision of culturally-sensitive Age-Friendly Care using the 4M’s in acute care or long-term care settings. ACTIVITIES TO ACCOMPLISH: a) Implement specialized training beyond the undergraduate BSN curriculum in the use of the 4M’s in the delivery of culturally-sensitive Age-Friendly Care that integrates the Social Determinants of Health using the 4M’s for Native and Rural Elders in Acute and Long-Term Care in Underserved Communities; b) Recruitment and admission according to Holistic Review criteria to recruit undergraduate nursing students from rural and educationally disadvantaged backgrounds; c) Collaborate with the HRSA-funded program at UND (RAIN) to identify networks for recruitment of disadvantaged undergraduate students into nursing; d) Support faculty 1.0 FTE to provide mentoring, advising, and tutoring service modeled after the RAIN program to promote students’ progression through the undergraduate curriculum, the advanced training, and to graduation; e) Select 16 students for monthly stipends annually, encourage undergraduate students from educationally disadvantaged backgrounds to apply; f) Empower and facilitate education and transition of nurses to nurse educator roles as Preceptor or Clinical Instructors for the GERO-STARR program in rural areas. Application forms to the GERO-STARR program will include a statement of intent signed by the student indicating that it is their intent to seek employment after graduation in acute care or long-term care settings in ND.
