No abstract

This study explores state-level efforts from 1999 through mid-2003 to address the nursing shortage in five midwestern states (Illinois, Iowa, Kansas, Missouri, Nebraska). The authors conducted interviews with 25 representative nurse leaders and others involved with state initiatives; this firsthand perspective provided useful insights on the interplay of various factors within states. For example, taskforce groups appointed to study the shortage were seen to evolve into broad-based and influential nursing coalitions. These coalitions advocated for establishing permanent state nursing centers to collect and analyze nurse workforce data and to improve nurse recruitment, retention, and the nurse practice environment. Expansion of educational programs faced barriers (nurse faculty shortages, limited clinical education sites) that were not readily amenable to solutions, in part because of state funding crises. This study illustrates how strategies are evolving in these states while highlighting the role of collaboration, creativity, and flexibility in solving this critical problem.

PURPOSE Oral disease has a major impact on the overall health of US children, with dental caries being the most prevalent chronic disease in this age group. Given nationwide shortages of dental professionals, interprofessional clinicians and staff with proper training can influence oral health access. The American Academy of Pediatrics created the Oral Health Knowledge Network (OHKN) in 2018 to bring together pediatric clinicians via monthly virtual sessions to learn from experts, share resources, and network. METHODSThe Center for Integration of Primary Care and Oral Health partnered with the American Academy of Pediatrics to evaluate the OHKN in 2021. The mixed method evaluation included an online survey and qualitative interviews among program participants.They were asked to provide information on their professional role and prior commitment to medical-dental integration as well as feedback on the OHKN learning sessions. RESULTSOf the 72 program participants invited, 41 (57%) completed the survey questionnaire and 11 took part in the qualitative interviews. Analysis showed that OHKN participation supported both clinicians and nonclinicians in integrating oral health into primary care. The greatest clinical impact was incorporating oral health training for medical professionals (cited by 82% of respondents), while the greatest nonclinical impact was learning new information (cited by 85% of respondents). The qualitative interviews highlighted the participants' prior commitment to medical-dental integration as well as drivers for their current medical-dental integration work.CONCLUSIONS Overall, the OHKN had a positive impact on pediatric clinicians and nonclinicians and, as a learning collaborative, successfully educated and motivated health care professionals to improve their patients' access to oral health through rapid resource sharing as well as clinical practice change.