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A framework for nursing practice in rural and remote Canada.

Michelle Pavloff1, Dana S Edge2, Judith Kulig3

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A new nursing practice framework synthesizes evidence to guide Canadian rural and remote nursing care. This framework aims to support the health of rural residents by informing various stakeholders and enhancing nursing practice.

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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.