| dc.description.abstract | Providing high quality and safe emergency care to patients in rural communities has become a complex and challenging problem. In the face of workforce shortages in emergency medicine, advanced practice providers (APPs) including nurse practitioners (NPs) and physician assistants (PAs) are being utilized to provide emergency care in rural hospitals. Authorities have recommended that APPs have specific experience or specialty training in emergency care (American College of Emergency Physicians [ACEP] Emergency Medicine Practice Committee, 2012). Despite these recommendations, there are few programs in the United States to formally educate APPs to the emergency care setting. This practice improvement project (PIP) identified current methods and gaps in education for APPs new to rural emergency care.
A needs assessment was conducted in critical access hospital (CAH) emergency departments in central Minnesota. APPs were asked about previous experiences, current methods of emergency care education, and to prioritize educational needs. The findings revealed that APPs without previous advanced practice emergency care experience are being employed in rural CAH emergency care settings. Length of orientation varied from less than a week up to three months. Priority education needs identified by APPs in rural emergency care included trauma, cardiopulmonary disorders, fracture management, sepsis, and neurological disorders.
Based on needs assessment results, a self-directed adult and pediatric trauma module was developed as one component of a comprehensive emergency care curriculum. During implementation and evaluation of the module, APPs and stakeholders from one rural CAH offered unanimous positive feedback that the adult and pediatric trauma would be helpful for an APP beginning practice in a rural emergency care setting. The PIP provided a glimpse into the educational backgrounds and experiences that APPs bring to the rural emergency care role. A wealth of high quality, online, and free material was compiled during the creation of a self-directed learning module for APPs in rural emergency care settings. Continued development of self-directed learning modules as part of the emergency care curriculum is recommended. Other areas that should be explored include providing learning opportunities within a larger volume emergency room, simulation, and periodic workshops or conferences. | en_US |
