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Grant supports advance practice nurses in rural and underserved areas

Advance practice nurses (APRNs) can gain additional training in rural and underserved areas with support from a nearly $2 million grant from the Health Resources and Services Administration (HRSA).

Busenhart talks with woman inside an exam room

Advance practice nurses will have an opportunity to gain additional training in rural and underserved areas with support from a nearly $2 million grant from the Health Resources and Services Administration (HRSA).

The University of Kansas School of Nursing accepted the four-year grant to fund a post-doctoral fellowship program for recent graduates of doctor of nursing practice (DNP).

"This program supports that new-graduate provider in building upon their core competencies," said Cara Busenhart, PhD, CNM, APRN, FACNM, clinical assistant professor in the KU School of Nursing and project director for the post-doctoral fellowship program.

"In addition, providers will focus on the expertise and experience of caring for rural or underserved communities, and how that may often change the complexity of the health care setting," she said.

Fellows might come from various specialties, including nurse practitioners in family practice, pediatrics and primary care, or other specialties such as nurse-midwife or women's health.

Partnering with places in need

For one year, the fellows will balance didactic learning with clinical practice in primary care, Busenhart said. In the beginning, a practitioner's patient load may be small to account for entry into a new field, but numbers will increase over time with the help of strong mentors.

"We're working with health systems to identify their greatest needs, asking what kind of providers they want," Busenhart said. "Ideally, we hope the fellowship program serves as a retention technique, to keep fellows in the system and in the rural or underserved areas."

Cynthia Teel, PhD, RN, FAAN, associate dean of academic affairs at the KU School of Nursing, said these fellows will learn a broad range of skills across diverse specialties. "We hope this (fellowship) will translate into enhanced resources for patients in rural communities, where health care provider availability is typically more limited."

Demand for primary care providers is increasing, and the shortage is pronounced in rural areas. According to the Medicare Payment Advisory Commission, only about 11 percent of the nation's physicians work in rural areas, even though 20 percent of the population lives in rural America.

Physicians in these areas often serve large geographic areas requiring significant travel time, and these areas may be substantially underserved by hospitals and other health care facilities.

Add the complication of an aging rural physician workforce treating an ever-climbing number of elderly patients in rural areas, and demand quickly outreaches supply.

Expanding the role of APRNs

HRSA believes one possible solution is expanding the role of advance practice registered nurses (APRNs) to meet the need for primary care services. As part of its grant, four doctoral-prepared fellows from a primary care specialty will participate during the first year of the program in 2020. By the program's completion in 2024, at least 15 DNP graduates will have completed the fellowship.

The School of Nursing's primary clinical partner in the grant is the University of Kansas Health System. Additional partners include the KU Center for Telemedicine and Telehealth, since HRSA has recognized telehealth as a priority area for funding and health workforce development, as well as:

  • KU Medical Center's Rural Health Education & Services
  • Sunflower Health Network
  • Community Care Network of Kansas

To be eligible for the fellowship, candidates must have graduated with their DNP between Jan. 1, 2019, and March 1, 2020. More details about the selection process are available on the fellowship website.

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