Factors That Encourage and Support Advanced Practice Registered Nurses to Work in Rural and Safety-Net Settings.

Area of Science:

• Health Services Research
• Nursing Workforce Studies
• Rural Health

Background:

• Advanced practice registered nurses (APRNs) are essential for healthcare delivery in underserved rural and safety-net areas.
• Existing research on provider recruitment and retention often prioritizes physicians, with less focus on APRNs specifically.

Purpose of the Study:

• To conduct a scoping review to identify effective strategies for recruiting and retaining APRNs in rural and safety-net settings.
• To identify research gaps concerning the APRN workforce in these critical practice environments.

Main Methods:

• A comprehensive scoping review of literature was performed.
• Databases searched included MEDLINE and CINAHL for articles published between 1990 and 2019.
• A total of 13 relevant articles were identified and analyzed.

Main Results:

• Educational experiences and loan repayment programs were key factors influencing APRNs' initial employment decisions in rural and safety-net settings.
• For rural practice retention, factors included community satisfaction, mentorship, supportive work environments, salary, and benefits.
• In safety-net settings, post-graduate Nurse Practitioner (NP) residency programs and team-based NP-physician care models were associated with retention.

Conclusions:

• There is a limited evidence base for strategies specifically targeting the recruitment and retention of APRNs in rural and safety-net locations.
• Further research is needed to develop and evaluate effective interventions to strengthen the APRN workforce in these underserved areas.