Rural Nursing and Evaluation of a Pediatric Outreach Program


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.  


Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share (for non-commerical purposes) the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).