A framework for nursing practice in rural and remote Canada.

Area of Science:

• Nursing Science
• Public Health
• Rural Health

Background:

• A gap exists in synthesized nursing frameworks for Canadian rural and remote practice.
• Understanding of Canadian rural and remote nursing has increased over the past two decades.

Purpose of the Study:

• To develop a nursing practice framework integrating existing rural and remote nursing evidence.
• To inform rural communities, health professionals, educators, policymakers, and regulators.
• To support the health of Canadian residents in rural and remote areas.

Main Methods:

• A focused international literature review identified existing rural nursing frameworks.
• Consultants collaborated with the Canadian Association for Rural & Remote Nursing (CARRN) Executive.
• An advisory group and expert researchers critiqued project outcomes.

Main Results:

• Literature analysis synthesized evidence into five categories: determinants of health, rural context, rural peoples/communities, rural/remote nursing, and health outcomes.
• A framework using concentric circles was developed and selected by the advisory group.
• The framework visually depicts interconnections within the rural context affecting client health.

Conclusions:

• The framework can strengthen nursing assessments and practice by highlighting rural context interconnections.
• Nursing programs could integrate the framework into curriculum and clinical discussions.
• Future revisions will benefit from ongoing critique from relevant rural groups, including Indigenous and Francophone nurses and community members.