SMSU Department Of Nursing
NURS 434
Module 3 Guide
Rural Healthcare Disparities
Description of Module:Now that the student has appraised the demographics of the rural population and the health disparities that are unique to the rural population, they will go on to use the skill of appraisal to gain knowledge about the healthcare disparities that the rural population faces. This knowledge will help the student to better understand the idiosyncrasies of rural populations to better meet their needs in the future.
Module Objectives:
- Appraise access to healthcare for the rural population
- Explain the scarcity of rural healthcare professionals
- Describe the impact of scarcity of rural healthcare professionals on inter professional collaboration
- Summarize rural healthcare disparities
Readings:
American Hospital Association. (2022). Rural hospital closures threaten access. https://www.aha.org/system/files/media/file/2022/09/rural-hospital-closures-threaten-access-report.pdf
Bell, N., Hung, P., Shi, K., Merrell, M., Crouch, E., & Eberth, J. M. (2021). Changes in
socioeconomic mix and health outcomes in rural counties with hospital closures, 2005-
- Rural & Minority Health Research Center. https://www.ruralhealthresearch.org/publications/1453
Constantin, J., Ullrich, F.K, & Mueller, K. J. (2022). Rural and urban pharmacy presence Pharmacy deserts. RUPRI Center of Rural Health. https://rupri.public-health.uiowa.edu/publications/policybriefs/2022/Pharmacy%20Deserts.pdf
Dill, J., Henning-Smith, C., Zhu, RE., &Vomacka, E. (2022). Who will care for rural older adults? Measuring the direct care workforce in rural areas. University of Minnesota Rural Health Research Center. https://rhrc.umn.edu/wp-content/uploads/2022/11/UMN-Policy-Brief_Who-will-care-for-rural-older-adults-1.pdf
Lahr, M., & Henning-Smith, C. (2021). Barriers to aging in place in rural communities: Perspectives from state offices of rural health. University of Minnesota Rural Health Research Center. https://rhrc.umn.edu/publication/barriers-to-aging-in-place-in-rural-communities/
Maxwell, A. W., Howard, H. A., & Pink, G. H. (2020). Geographic variation in the 2018
profitability of urban and rural hospitals.North Carolina Rural Health Research Program. https://www.shepscenter.unc.edu/product/geographic-variation-in-the-2018-profitability-of-urban-and-rural-hospitals/
McBride, T., Barker, A., Hernandez, E., Jost, E., Kemper, L., & Mueller, K. (2022). An insurance profile of rural America: Chartbook. Rural Policy Research Institute. https://rupri.public-health.uiowa.edu/publications/other/Rural%20Insurance%20Chartbook.pdf
Mead, A. (2022). Telehealth brings important services to rural long-term care facilities. Rural Health Information Hub. https://www.ruralhealthinfo.org/rural-monitor/long-term-care-telehealth/
National Academies of Sciences, Engineering, and Medicine: National Academy of Medicine; Committee on the Future of Nursing 2020-2030. (2021). The nursing workforce. In M. K. Wakefield, D. R. Williams, S. Le Menestrel, & J. L. Flaubert (Eds.), The future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK573922/?report=printable
National Public Radio, Robert Wood Johnson Foundation, &Harvard T. H. Chan School of
Public Health. (2019). Life in rural America: Part II.https://media.npr.org/documents/2019/may/NPR-RWJF-HARVARD_Rural_Poll_Part_2.pdf
Parris, M. (2015). U.S. nursing workforce: Supply and education trends.Nova Science
Publishers, Inc.
Read Chapter 1, Section 1
Pink, G. H., Osgood, A., & Sana, P. (2020). A comparison of rural and urban specialty hospitals.North Carolina Rural Health Research Program. https://www.ruralhealthresearch.org/alerts/369
Rural Health Research RECAP. (2022). Maternal health disparities: An intersection of race and rurality. https://www.ruralhealthresearch.org/assets/5015-22509/maternal-health-disparities-recap.pdf
Rural Health Research RECAP. (2022). Travel burden to receive health care.https://www.ruralhealthresearch.org/assets/4993-22421/travel-burden-recap.pdf
U.S. Government Accountability Office. (2022). Maternal health: Availability of hospital-based obstetric care in rural areas. https://www.gao.gov/assets/gao-23-105515-highlights.pdf
Washington, Wyoming, Alaska, Montana, Idaho Rural Health Research Center. (2021).
Geographic access to health care for rural Medicare beneficiaries: A national study.
https://familymedicine.uw.edu/rhrc/wp-content/uploads/sites/4/2021/09/RHRC_PBSEP2021_LARSON.pdf
Websites:
Rural Health Information Hub. (2020). Rural healthcare quality.
https://www.ruralhealthinfo.org/topics/health-care-quality
Rural Health Information Hub. (2023). Rural healthcare workforce. https://www.ruralhealthinfo.org/topics/health-care-workforce?utm_source=racupdate&utm_medium=email&utm_campaign=update031523
Rural Health Information Hub. (2022). Rural hospitals.
https://www.ruralhealthinfo.org/topics/hospitals
Rural Health Information Hub. (2022). Rural hunger and access to healthy food.
https://www.ruralhealthinfo.org/topics/food-and-hunger
Rural Health Research Gateway. (2019). Rural obstetric services: Access, workforce, and
impact.https://www.ruralhealthresearch.org/recaps/8
Optional Readings:
Akinlotan, M., Primm, K., Khkodakarami, N., Bolin, J., & Ferdinand, A. O. (2021). Rural-urban
variations in travel burdens for care: Findings from the 2017 National Household Travel
Survey. Southwest Rural Health Research Center. https://www.ruralhealthresearch.org/alerts/423
Barker, A. R., Nienstedt, L., Kemper, L. M., McBride, T. D., & Mueller, K. J. (2018). Health
insurance marketplaces: Issuer participation and premium trends in rural places, 2018. Rural Health Research & Policy Centers & Rural Policy Research Institute.
https://www.ruralhealthresearch.org/alerts/248
Health Resources and Services Administration. (2018). Nursing workforce dashboard. https://data.hrsa.gov/topics/health-workforce/nursing-workforce-dashboards?utm_source=govdelivery&utm_medium=email&utm_campaign=NEW%3A%2BHRSA%2BReleases%2BNursing%2BWorkforce%2BDashboard
Henning-Smith, C., Cross, D., & Rahman, A. (2021). Challenges to admitting residents:
Perspectives from rural nursing home administrators and staff. INQUIRY:The Journal of
Health Care Organization, Provision, and Financing, 58, 1-8.
Interrante, J. D., Tuttle, M. S., Ibrahim, B. B., Admon, L. K., &Kozhimannil, K. B. (2021). State
and regional differences in access to hospital-based obstetric services for rural residents,
- 2018. University of Minnesota Rural Health Research Center.https://rhrc.umn.edu/publication/state-and-regional-differences-in-access-to-hospital-based-obstetric-services-for-rural-residents-2018/
Kozhimanil, K. B., Interrante, J. D., & Tuttle, M. S. (2020). Loss of hospital-based obstetric services in rural counties in the United States, 2004-2018. University of Minnesota Rural Health Research Center. https://rhrc.umn.edu/publication/loss-of-hospital-based-obstetric-services-in-rural-counties-in-the-united-states-2004-2018/
Lazaro, E., Ullrich, F., & Mueller, K. J. (2022). Update on rural independently owned pharmacy closures in the United States, 2003-2021. RUPRI Center for Rural Health. https://rupri.public-health.uiowa.edu/publications/policybriefs/2022/Independent%20Pharmacy%20Closures.pdf
National Center for Health Workforce Analysis. (2017). Supply and demand projections
of the nursing workforce: 2014-2030. U.S. Department of Health and Human Services, Health Resources and Services Administration. https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/NCHWA_HRSA_Nursing_Report.pdf
Owen, A. L., Davis, A., &Balazs, S. (2022). County-level availability of obstetric care and economic implications of hospital closure on obstetric care. Rural Health Research Gateway.https://www.ruralhealthresearch.org/alerts/495
Parker, J. (2022). Rural hospices, patient encounter higher needs, fewer options. Hospice News.
https://hospicenews.com/2022/04/11/rural-hospices-patients-encounter-higher-needs-fewer-options/
Sharma, H., Baten, R. B. A., Ullrich, F., MacKnne, A. C. & Mueller, K. J. (2021). Trends in
nursing home closures in nonmetropolitan and metropolitan counties in the United States, 2008–2018. Rural Health Research & Policy Centers & Rural Policy Research Institute. https://www.ruralhealthresearch.org/publications/1410
Washington, Wyoming, Alaska, Montana, Idaho Rural Health Research Center. (2021).
Geographic access to health care for rural Medicare beneficiaries: A national study.
https://familymedicine.uw.edu/rhrc/wp-content/uploads/sites/4/2021/09/RHRC_PBSEP2021_LARSON.pdf
Zachrison, K. S., Richard, J. V., & Mehrotra, A. (2021). Paying for telemedicine in smaller rural hospitals. JAMA Health Forum, 2(8), e211570. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2783655#:~:text=Typically%2C%20ED%20visits%20are%20reimbursed,reimburse%20the%20remote%20specialist%2Dconsultant.
Video:
A Day in the Life of a Rural Nurse
https://nursing.utah.edu/blog/2022/08/nepqr-rural-nurse-film(look at bottom of page)
Resources:
American Psychological Association (2020). Publication manual of the American
Psychological Association (7th ed.).
NURS 434 Discussions Review Video and Outline
NURS 434 Rural Healthcare Disparities Paper Review Video and Outline
NURS 434 Rural Healthcare Disparities Paper Draft Review
Assignments:This module is completed during the third and fourthweeks of NURS 434.The discussion and paper assignment due dates are found in the NURS 434 schedule.
Module 3 – Assignments:
1. Utilize Readings/Resources provided above
2. View: NURS 434 Discussions Review Video
3. Discussion 1 (20 points)
- Assignment not a collaborative team assignment. This assignment is to be completed individually by each student.
- Following review of the Readings/Resources provided for you, including viewing of the NURS 434 Discussions Review Video in Module 3, post a response to one of the questions listed below.Be sure to follow the discussion rubric guidelines found in the NURS 434 syllabus, Appendix A. Please note the due dates for postings in the NURS 434 schedule provided. It is important to know that as your instructor, I am sensitive to your busy schedules with family, work, and school. There are due dates for postings, created to allow productive discussions between yourself and your peers. If you ever feel that meeting a due date creates a significant challenge for you, please let me know and we will discuss an alternative plan for you. If I do not hear from you, the grading criteria for late submissions will be followed.
- After the student completes their initial posting, and has responded to at least two other students, the student will self-grade their discussion using the discussion quiz, located within NURS 434 Module 3 content area. The student’s self grade will be reviewed by the course instructor for accuracy, and adjusted as needed.
You may respond to both questions below:
First: Prior to completing this discussion assignment, contact a healthcare professional from a non-nursing profession and discuss how the possibility of not having access to their profession in rural healthcare would impact the rural population.
Question 1: Access to healthcare for the rural population differs from the urban population. What are three challenges the rural population faces that creates more difficulty accessing healthcare? How does the lack interprofessional collaboration, due to the lack of healthcare professionals, impact the rural population? What did you learn from interviewing a non-nursing health professional about this topic and how it can impact rural populations? How do these challenges accessing healthcare lead to health status disparities? In your opinion, how could we decrease these healthcare disparities? Utilize the Rural Health Information Hub resource titled Rural Healthcare Quality listed in the required readings. Discuss how one of the quality initiatives provided in this resource could make a positive impact on your idea about how we could decrease healthcare disparities. Lastly, please share your feelings about the value of the quality initiatives, such as those found in Rural Healthcare Quality, on decreasing healthcare disparities.
Question 2: The number of healthcare professions is different in rural vs. urban settings. What are three of those differences for rural vs. urban healthcare settings? What healthcare professions are noted to be scarce in rural healthcare settings? How does the lack interprofessional collaboration, due to the lack of healthcare professionals, impact the rural population? What did you learn from interviewing a non-nursing health professional about this topic and how it can impact rural populations? In your opinion, how could we best reduce the scarcity of these healthcare professionals? Utilize the Rural Health Information Hub resource titled Rural Healthcare Quality listed in the required readings. Discuss how one of the quality initiatives provided in this resource could make a positive impact on your idea about how we could reduce the scarcity of healthcare professionals. Lastly, please share your feelings about the value of the quality initiatives, such as those found in Rural Healthcare Quality, on decreasing the scarcity of healthcare professionals.
- Rural Healthcare Disparities Paper(second portion of sequencing paper in NURS 434 that will be a part of the final Care of the Rural Population Paper)
Throughout this course, you will write a Care of the Rural Population Paper. This will be a sequencing paper – meaning you will write the paper as four separate assignments, and put those four assignments together at the end of this course to create your final Care of the Rural Populations Paper.
During Module 3, you will write the second portion of your paper. This portion of your final paper will be aboutRural Healthcare Disparities.
View: NURS 434 Rural Healthcare Disparities Paper Review Video – view prior to starting this assignment (found in Module 3). An outline of the video content is provided as a resource for you to take notes on as you view the video.
Rural Healthcare Disparities-Second portion of paper
Each student, or team of students, will create at least aone to two page paper describing rural healthcare disparities, including the scarcity of rural healthcare professionals, with the rural population having challenges accessing healthcare.If you have done Discussion 1, you have had the opportunity to use reviewthe readings and resources that will be useful for this paper.The paper will be professionally written and in APA format. Also, additional resources include the use of Tutor.comand the SMSU Writing Center for writing support as well as the availability of a draft review for this paper. These resources are totally optional but encouraged. The draft review is provided to provide feedback regarding the content of your paper. Writing mechanics, style, and APA formatting feedback may be sought using Tutor.comor the SMSU Writing Center.
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Appendix C – Rural Healthcare Disparities Grading Rubric
| CONTENT | Excellent | Satisfactory | Unsatisfactory |
| Expands on the description of the landscape of life in rural settings and rural populations by describing: 1) differences in rural healthcare services available, compared to urban areas
2) scarcity of rural healthcare professionals
3) supply of nursing workforce in rural healthcare settings
4) challenges the rural population faces when accessing healthcare
| Describes differences in rural healthcare services available, compared to urban areas (5 points)
Describes scarcity of rural healthcare professionals(5 points)
Describes the supply of nursing workforce in rural healthcare settings (5 points)
Describes the challenges the rural population faces when accessing healthcare (5 points) | Partial description of the differences in rural healthcare services available, compared to urban areas (2.5 points)
Vague description of the scarcity of rural healthcare professionals (2.5 points)
Vague description of the supply of nursing workforces in rural healthcare settings (2.5 points)
Vague description of the challenges the rural population faces when accessing healthcare (2.5 points)
| No description of the differences in rural healthcare services available, compared to urban areas (0 points)
No description of the scarcity of rural healthcare professionals (0 points)
No description of the supply of nursing workforces in rural healthcare settings (0 points)
No description of the challenges the rural population faces when accessing healthcare (0 points) |
| ORGANIZATION FOR EFFECTIVENESS | |||
| APA Format and editorial style – use of APA formatting, avoiding plagiarism by adhering to the rules for paraphrasing, summarizing, and the use of quotations, as well as the conventions for incorporating information from Internet-based resources. Any materials drawn from resources are properly cited and documented in APA format.
Reference list is provided in APA format.
Demonstrates how to appropriately organize work per APA formatting with the use of headings – start this assignment with an APA Level 1 heading titled: Rural Healthcare Disparities. No title page required. |
Materials drawn from resources are properly cited and documented in APA format (2 points)
Reference list is provided in APA format (2 points)
Demonstrates how to appropriately organize work per APA formatting with the use of headings – starting this assignment with an APA Level 1 heading titled: Rural Healthcare Disparities. (2 points) |
Some of the materials drawn from resources are properly cited and documented in APA format (1 point)
Reference list is provided but not completely in APA format (1 point) Demonstrates how to appropriately organize work per APA formatting with the use of headings – but did not use the pre-defined APA Level 1 heading titled: Rural Healthcare Disparities. (1 point) |
No materials drawn from resources are properly cited and documented in APA format (0 points)
No reference list is provided (0 points)
No organization using APA headings (0 points) |
| Organization is clear and coherent; order and structure are present; clear sequencing and paragraphing. | Organization is clear and coherent; order and structure are present; clear sequencing and paragraphing (5 points) | Organization is partially clear without order and structure (2.5 points) | Lack of organization throughout paper (0 points) |
| Contains rare punctuation, spelling, and/or capitalization errors. | Contains rare punctuation, spelling, and/or capitalization errors (4 points) | Contains several punctuation, spelling, and/or capitalization errors (2 points) | Contains many punctuation, spelling, and/or capitalization errors (0 points) |
| Writing is clear and focused. Reader can easily understand the main idea. The main idea is incorporated into the text in a manner appropriate for the practice of nursing. | Writing is clear and focused. Reader can easily understand the main idea. The main idea is incorporated into the text in a manner appropriate for the practice of nursing (5 points) | Writing is lacking clarity and focus. Reader cannot easily understand the main idea. The main idea is not incorporated into the text in a manner appropriate for the practice of nursing (2.5 points) | No clarity or focus (0 points) |
| Integrated two professional resources into the paper, using high quality electronic sources of healthcare information. | Accesses and uses two professional journal articles to demonstrate information literacy (2 points) | Accesses and uses one professional journal article to demonstrate information literacy (1 point) | Uses no professional journal articles (0 points) |
| Paper is a minimum length of 1-2 pages (not including reference list). | Paper is a minimum of 1 page in length, not including the title page and reference list. No abstract is necessary (3 points) | Paper is 0.75 pages in length, not including the title page and reference list. No abstract is necessary (1.5 points) | Paper is less than 0.5 page in length, not including the title page and reference list (0 points) |
| TOTAL POINTS | 45 |
*If collaborating in a team, all team members must submit this assignment in their
assignment dropbox.
- Checklist:A checklist has been created for you own personal use in each module in NURS 434. If you choose to use the checklist tool, it may provide you with a system to double check if you have everything done for each module.
