In the rural setting, emergencies present as high stress situations and can have significant consequences for the patient, family, provider, and hospital staff involved. Many rural hospitals rely heavily on nurse practitioners (NPs) to provide care for the community as well as covering the emergency department. Thorough education in emergency training and skill competencies are essential when taking on the role of a provider in rural facilities and critical access hospitals. When a critically ill patient presents to a rural emergency department, an NP may be the only provider available, therefore, having increased education and continued sustainment of emergency care skills is critical for patient safety and outcomes. The purpose of the practice improvement project was to evaluate the educational needs of rural NPs covering emergency departments within the Midwest region and develop an education seminar to increase the perceived knowledge and preparedness of NPs’ emergency care skills. Secondary analysis of the Rural Nurse Practitioner Skill Needs Assessment data survey results were utilized to evaluate the perceived level of preparedness among rural novice NPs in the Midwest region in performing emergency care skills. Findings from the needs assessment were analyzed to facilitate the development of a one day education seminar, Emergency Care Skills Seminar. The education seminar covered three emergency care skills: procedural sedation, emergency airway management, and arthrocentesis. Participants were rural NPs and third year Doctor of Nursing Practice (DNP) students. Pre- and post-seminar surveys were provided to participants via Qualtrics to evaluate their perceived level of preparedness on the three educational topics covered in the education seminar. Comparison of the pre- and post-seminar survey showed an increase in the participants’ perceived level of preparedness in preforming the three emergency care skills covered in the Emergency Care Skills Seminar. The project can serve as a framework for an annual education seminar offered to practicing NPs for emergency care skill preparedness and sustainment. The project could also be a guide for an emergency care curriculum for NP students to take as an elective course to better prepare them for rural practice.