A framework for nursing practice in rural and remote Canada

Introduction: Despite the increased understanding of Canadian rural and remote nursing practice in the past two decades, a synthesis of nursing frameworks to guide practice has been missing from the literature. In this article, the process undertaken to develop a nursing practice framework is des...

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Main Authors: Michelle Pavloff, Dana Edge, Judith Kulig
Format: Article
Language:English
Published: James Cook University 2022-08-01
Series:Rural and Remote Health
Subjects:
Online Access:https://www.rrh.org.au/journal/article/7545/
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author Michelle Pavloff
Dana Edge
Judith Kulig
author_facet Michelle Pavloff
Dana Edge
Judith Kulig
author_sort Michelle Pavloff
collection DOAJ
description Introduction: Despite the increased understanding of Canadian rural and remote nursing practice in the past two decades, a synthesis of nursing frameworks to guide practice has been missing from the literature. In this article, the process undertaken to develop a nursing practice framework is described. The purpose of the project was to integrate existing rural and remote nursing evidence into a framework to guide rural nursing practice; inform the actions of rural communities, other health professionals, educators, policymakers and regulators; and support the health of Canadian residents who live in rural and remote areas. Methods: Two consultants (DE, JK) worked with the Canadian Association for Rural & Remote Nursing (CARRN) Executive to plan and implement a process to develop a rural and remote nursing framework. An external advisory group, representing regulated nurses, and six expert rural nursing researchers were invited to critique project outcomes. A focused international review of the literature was conducted to determine which rural nursing frameworks existed. Electronic database platforms (ProQuest and the Cumulative Index of Allied Health Literature and Medline) were searched, with literature limited to English-only articles. Each article was analyzed to determine relevant key components and elements. Results: The literature review generated 22 full-text articles that were analyzed and synthesized into five main categories: larger society/determinants of health, role of place/the rural or remote context, rural and remote peoples/communities, rural and remote nursing, and health outcomes. A draft document describing the creation of the framework and two different graphic designs of the framework were developed, then sent to the advisory group for critique. All critiques were reviewed and the document was revised as appropriate. The framework design, which used concentric circles to depict relationships between the five identified categories, was selected by a majority of the advisory group reviewers as being representative of their practice and experience. Conclusion: It is envisioned that, by using the framework, practicing nurses can identify the tightly woven interconnections within the rural context affecting the health of their clients. Nursing assessments and practice can then be strengthened from consideration of the framework. Nursing programs with dedicated rural nursing content potentially could incorporate the rural and remote nursing practice framework document into classroom and clinical discussions. Due to resource and time restrictions, Indigenous and Francophone nurses were not part of the framework discussions, nor were community members living in rural or remote Canada. Ongoing critique from relevant rural groups will be beneficial for future input and revisions. CARRN is developing a knowledge mobilization strategy to begin this process.
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spelling doaj.art-5ffd48dab2944793b40a1e0b1f4c67f52022-12-22T01:43:08ZengJames Cook UniversityRural and Remote Health1445-63542022-08-012210.22605/RRH7545A framework for nursing practice in rural and remote CanadaMichelle Pavloff0Dana Edge1Judith Kulig2School of Nursing & Health Sciences, Saskatchewan Polytechnic, 1130 Idylwyld Drive, Saskatoon, Saskatchewan S7K 3R5, CanadaSchool of Nursing, Queen’s University, 92 Barrie Street, Kingston, Ontario K7L 3N6, CanadaFaculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, Alberta T1K 3M4, Canada Introduction: Despite the increased understanding of Canadian rural and remote nursing practice in the past two decades, a synthesis of nursing frameworks to guide practice has been missing from the literature. In this article, the process undertaken to develop a nursing practice framework is described. The purpose of the project was to integrate existing rural and remote nursing evidence into a framework to guide rural nursing practice; inform the actions of rural communities, other health professionals, educators, policymakers and regulators; and support the health of Canadian residents who live in rural and remote areas. Methods: Two consultants (DE, JK) worked with the Canadian Association for Rural & Remote Nursing (CARRN) Executive to plan and implement a process to develop a rural and remote nursing framework. An external advisory group, representing regulated nurses, and six expert rural nursing researchers were invited to critique project outcomes. A focused international review of the literature was conducted to determine which rural nursing frameworks existed. Electronic database platforms (ProQuest and the Cumulative Index of Allied Health Literature and Medline) were searched, with literature limited to English-only articles. Each article was analyzed to determine relevant key components and elements. Results: The literature review generated 22 full-text articles that were analyzed and synthesized into five main categories: larger society/determinants of health, role of place/the rural or remote context, rural and remote peoples/communities, rural and remote nursing, and health outcomes. A draft document describing the creation of the framework and two different graphic designs of the framework were developed, then sent to the advisory group for critique. All critiques were reviewed and the document was revised as appropriate. The framework design, which used concentric circles to depict relationships between the five identified categories, was selected by a majority of the advisory group reviewers as being representative of their practice and experience. Conclusion: It is envisioned that, by using the framework, practicing nurses can identify the tightly woven interconnections within the rural context affecting the health of their clients. Nursing assessments and practice can then be strengthened from consideration of the framework. Nursing programs with dedicated rural nursing content potentially could incorporate the rural and remote nursing practice framework document into classroom and clinical discussions. Due to resource and time restrictions, Indigenous and Francophone nurses were not part of the framework discussions, nor were community members living in rural or remote Canada. Ongoing critique from relevant rural groups will be beneficial for future input and revisions. CARRN is developing a knowledge mobilization strategy to begin this process. https://www.rrh.org.au/journal/article/7545/Canadacommunityframeworkhealth determinantsnursingrural health care.
spellingShingle Michelle Pavloff
Dana Edge
Judith Kulig
A framework for nursing practice in rural and remote Canada
Rural and Remote Health
Canada
community
framework
health determinants
nursing
rural health care.
title A framework for nursing practice in rural and remote Canada
title_full A framework for nursing practice in rural and remote Canada
title_fullStr A framework for nursing practice in rural and remote Canada
title_full_unstemmed A framework for nursing practice in rural and remote Canada
title_short A framework for nursing practice in rural and remote Canada
title_sort framework for nursing practice in rural and remote canada
topic Canada
community
framework
health determinants
nursing
rural health care.
url https://www.rrh.org.au/journal/article/7545/
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