Advancing the Practice of Nursing to Address Rural Healthcare Needs

Principal Investigator(s)

Barbara Barnes, MD and Lisa Fiorentino, PhD, MA, MS

Providing access to high-quality and cost-effective has been an ongoing challenge for rural areas, given inherent issues with distributed, sparse populations and challenges in the recruitment and retention of healthcare providers.   Pennsylvania has the third largest rural population in the country, with one-half of physicians and over one-quarter of nurses practicing in only 3 of the 67 counties.

This research project was designed to provide an assessment of educational preparedness of nurses within a 7-county area of northern Pennsylvania (Cameron, Clinton, Elk, Forest, McKean, Potter, and Warren counties), to identify barriers to achievement of more advanced undergraduate and graduate degrees, and to propose potential strategies to prepare the nursing workforce to support models of care that improve access, quality and cost-effectiveness of care to this rural population.  Key components of the project will included:

  • An analysis of the current nursing workforce in the region: We will review the most recent Pennsylvania Department of Health Survey of Registered Nurse data to determine the educational attainment of nurses within the 7-county area to determine inter-county variation as well as comparison with other areas of the state.  In particular, it was used to determine if there are higher proportions of bachelor-level nurses in counties such as Warren, Clinton, and Potter that are contiguous to counties with a university offering these programs.  
  • A description of available educational programs and analysis of barriers to matriculation and graduation: In addition to assessment of student recruitment and demographic information, attrition, and job placement at the University of Pittsburgh at Bradford campus, researchers performed interviews with local higher education institutions that offer baccalaureate programs.
  • A survey of hospitals within the region to determine interest in advancing education of their nursing workforce: interviews were conducted with chief nursing officers from hospitals within the 7-county region to identify initiatives to further the education of their nursing workforce and determine attitudes about expanded scope of nursing practice in new models of care. Innovative practices were identified.
  • Convening of an expert task force to review the results of the above work and formulate recommendations for strategies to further develop the regional nursing workforce:  A task force of experts will summarize the results of the project in a formal report, which will include implementation strategies and proposals for additional work.