Identifying the educational needs of emergency nurses in rural and critical access hospitals.

This study was conducted to determine educational needs and identify potentially effective educational modalities for emergency nurses working in rural and critical access hospitals. Although 50% of all emergency department visits to critical access hospitals are low-acuity cases, the 4.0% transfer rate in critical access hospitals is significantly higher than the 1.5% overall transfer rate. Nursing issues include the required breadth and depth of skills needed by emergency nurses in recognizing, stabilizing, and transferring patients who require a higher level of care. Thirty-three emergency nurses practicing in rural or critical access hospitals were recruited for a focus group discussion of educational needs, barriers, and facilitators. The discussion was transcribed, and constant comparison was used to identify themes. Participants identified a need for further education in the care of critically ill patients, those who have undergone bariatric surgery, geriatric patients, those with traumatic injury, and those with mental health issues. Themes included educational isolation and limited availability of resources. Developing and delivering continuing education to this significantly isolated practice community is vital to safe patient care.