Rural Nursing and Evaluation of a Pediatric Outreach Program


  • Cory Risse Washington State University
  • Jo Ann Walsh Dotson Washington State University
  • Denise Smart Washington State University
  • Debbie Brinker Washington State University



Introduction: Rural nurses face barriers and challenges in obtaining continuing education, which contribute to the challenge of maintaining competency while working in a setting that expects proficiency in low volume, high risk procedures. 

Purpose: The purposes of this project were to 1) examine the literature related to pediatric care delivery in rural health care settings and continuing education needs of rural nurses and effective education strategies and 2) analyze the effectiveness of a pediatric outreach program’s educational and professional development interventions (Transforming Inpatient Care and Culture [TICC]) in a rural hospital in Washington State. 

Methods: The literature review employed key words to search databases on the topics of “rural nursing”, “continuing education”, “outreach”, “pediatrics”, and related concepts. Evaluation of the TICC project consisted of comparing pre and posttest results from a 40 item questionnaire for those who participated in the TICC project following an 8 hour training session.  Participants included 66 nurses who participated in the training at the hospital and completed the post test. The means of overall and topic specific pre and post test results were examined.

Results:  There was statistically significant improvement in overall pre to post test performance (p = .005) and in one of the three priority areas, synthesis of care decisions (p = .028). There was also improvement in test performance on the two remaining priority areas, knowledge of equipment and interventions and pediatric specific assessment, although the improvement did not reach statistical significance. 

Conclusion: A rural pediatric outreach program can be an efficient and effective way to address the continuing education needs of rural nurses in a hospital setting.  The project serves as a guide for identifying and addressing the pediatric educational needs of nurses, while empowering the very nurses who care for patients in the facility to be part of the leadership and innovation process.  The implementation of a pediatric outreach program could be instrumental in improving pediatric patient care in the rural setting.  


Author Biographies

Cory Risse, Washington State University

Cory Risse, MN, RN


Washington State University, College of Nursing


Jo Ann Walsh Dotson, Washington State University

Jo Ann Walsh Dotson PhD, RN

Assistant Professor

Washington State University, College of Nursing

Denise Smart, Washington State University

Denise Smart, DrPH, MPH, RN

Associate Professor

Washington State University, College of Nursing

Debbie Brinker, Washington State University

Debbie Brinker, MSN, RN

Clinical Assistant Professor and Director of Experiential Learning

Washington State University, College of Nursing