To help address access to health care for rural and underserved areas, registered nurses can take on expanded roles in primary care delivery. Many registered nurses have not been fulfilling these roles which are within the scope of their licensing.

"Nurses can practice to the full scope of the RN license and expand their scope of influence within the community-based primary care team," said South Dakota State University Associate Nursing Professor Heidi Mennenga.

She pointed to care management, such as the hospital-to-home transition or management of chronic health conditions, and administration of warfarin, a prescription medication designed to prevent blood clots, as examples.

Mennenga will lead a nursing team that will train senior nursing students and practicing RNs to expand their roles in the primary care setting through a four-year, nearly $2.8 million grant from U.S. Health Resources and Services Administration (HRSA).

According to the 2011-2015 South Dakota Primary Care Needs Assessment, 48 of the 66 counties in the state are designated by HRSA as medically underserved areas/populations, meaning they have too few primary care providers, high infant mortality, high poverty or high elderly populations.

One of the goals of the grant project, IMPACT-RNS-; Impacting Models of Practice and Clinical Training for Registered Nurses and Students, is to prepare 1,032 nursing students and at least 260 practicing RNs to function in these expanded roles.

Developing a curriculum to train students

In addition to classroom instruction and laboratory simulations, a select group of nursing students will receive 150 hours of clinical training at one of 13 health-care facilities in South Dakota and Minnesota that serve diverse populations.

"We currently use most of these clinical sites, just not in this capacity," Mennenga explained. "That's why it's important to have site leaders as part of the research team on each campus who are the contact point for those clinical facilities."

Identifying opioid addiction

Another major aspect of the project will be to train nurses regarding their role in addressing the opioid epidemic, including the assessment, intervention, and evaluation of opioid use disorders. "Opioid use is a public health concern, not only in the nation but the state as well," Mennenga said.

Health Systems Development and Regulation Division Director Tom Martinec, who chairs the opioid initiative advisory committee, will serve as a resource for the SDSU team developing the opioid content. The professional development training related to opioid use will be delivered online, so it is accessible to practicing nurses at the participating facilities.

"By year four, we want to be able to have it more widely available to share with facilities across the state, not just those working with us during the grant project," Mennenga said.

Furthermore, she noted, "We will have lots of ways to evaluate the entire curriculum and training and will then make changes based on detailed program objectives."