What are some interventions nurses can implement to mitigate the impact of these barriers?

Posted: January 26th, 2023

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Module 3: Rural Health Disparities
This module introduces some of the health disparities that are a reality for many rural dwellers.
Approaches nurses can utilize to mitigate the impact of some disparities will be addressed.
Module Objectives:
1) Appraise barriers to optimal health care that exist in rural areas.
2) Analyze factors that impact access to care in rural areas.
3) Explore consequences of limited access to healthcare.
4) Explore ways nurses can promote health in areas of limited health care access.
Assigned readings:
Bushy, A. (2013). Health Disparities in Rural Populations Across the Lifespan. In C.A. Winters (Ed.), Rural
nursing: Concepts, theory, and practice (pp.225 – 239). Springer.
http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sw
w&AN=547705&scope=site
American Nurses Association (2015). Code of ethics for nurses: With interpretive statements. Silver
Spring, MD: ANA. (choose portions that will be valuable in your synthesis and application post)
https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk
&AN=1021757&scope=site
COVID – 19 and Rural Health Care. (2020). Online Journal of Rural Nursing & Health Care, 20(1),
1–5. https://doi.org/10.14574/ojrnhc.v20i1.626. Available at
https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&d
b=ccm&AN=143781889&scope=site
Erwin, C., Aultman, J., Harter, T., Illes, J., & Kogan, R. C. J. (2020). Rural and Remote
Communities: Unique Ethical Issues in the COVID-19 Pandemic. American Journal of Bioethics,
20(7), 117–120. https://doi.org/10.1080/15265161.2020.1764139.
https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&d
b=ccm&AN=144785432&scope=site
Shreffler-Grant, J.M., Nicols, E., Weinert, C, & Ide, B. (2013). Complementary Therapy and Health
Literacy in Rural Dwellers. In C.A. Winters (Ed.), Rural nursing: Concepts, theory, and practice
(pp.205- 214). Springer.
http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sw
w&AN=547705&scope=site
Be sure to take adequate time to peruse Rural Health Information (RHI) Hub and Center for Disease
Control (CDC) sites as well as other information linked into this module
Key points
• Communities in rural areas are impacted by policies developed at the national level.
• Competition between rural and urban areas in the domain of healthcare occurs increasingly as
resources become scarcer.
• Healthcare policies impact rural and urban areas in unique ways.
• A variety of social determinants may impact the health of individuals and families.
• Although health disparities occur in all settings, there are a number that are particularly
noteworthy in rural areas.
• Poverty often compounds other risks and vulnerabilities.
• A high proportion rural residents are among the ‘working poor’ and uninsured. Low income
correlates with lower educational levels, poorer nutrition, fewer preventative health care
practices, increased risk of trauma, developmental delays, inadequate immunization, and
increased chronic illness.
• Rural people are often older. Many elderly adults have a low fixed income, relying primarily on
social security benefits. They may have difficulty accessing additional benefits
Graded Assignment:  
You will complete your next synthesis and application assignment. Synthesis and Application
assignments have two separate components. Please see the information in the Synthesis and
Application Assignment folder for a video and more detailed direction. Refer to the grading rubric
(Appendix B in your syllabus or at the end of this document) for how points can be earned.  Carefully
note the criteria for a professional nursing journal as found in the course syllabus (p. 9). 
Part 1: Choose one of the situations /topics below. You may need to refer back to information from
prior assigned readings in addition to the readings assigned for this module. Respond to the situation
you choose in the discussion forum adhering to the grading rubric in Appendix B. Note that all parts of
the discussion question/topic must be addressed to earn full points.  You can earn up to 15 points for
your initial post.
Part 2: There is an opportunity to review what your peers have posted and build on their knowledge and
insights by the date included on the course schedule.  You will post a substantive addition to one of your
peers' post. Your substantive addition must address the topic/situation other than the topic/ situation
addressed in your original synthesis and application post. You can earn up to 10 points a substantive
addition that meets rubric criteria.
As you search for articles the first weeks of this course, two journals that may be especially helpful are
the Online Journal of Rural Nursing and Health Care and the Journal of Rural Health.  Both are readily
accessible via the SMSU library.  There are many other articles and journals that will be helpful as well.
Topic One
1. Examine three barriers that may impact access to health care (not including lack of services) that may
be especially prevalent in rural areas in the United States. Note: A professional examination
regarding this question should include at least three well thought out and professionally written
sentences examining each of the three barriers you choose.
2. What are some interventions nurses can implement to mitigate the impact of these barriers?
3. Compare and contrast potential barriers to access to care in rural versus urban areas.
Topic Two
1. How might limited access to health care impact the use of complementary and alternative therapies?
2. Discuss the long-term consequences of limited access to health care services. Include how limited
access impacts individuals, families, and the health care system.
3. Briefly discuss two provisions from the Code of Ethics with Interpretive Statements that are relevant
when considering health care disparities.
Appendix B: Synthesis and Application Assignment rubric
Remember that integrating your own thoughts with evidence from the literature is an effective to
demonstrate synthesis and critical analysis. Sometimes a few short direct quotes add value to your
work. But remember that long quotes generally serve to share someone else's thoughts, rather than
your analysis.
Please refer to the Synthesis and Application folder for a more detail and guidance.
Primary post
Criterion Excellent Competent Not satisfactory
Complete All questions from one chosen
scenario/topic addressed in a
clear, focused manner. All
responses demonstrate critical
analysis (3 points)
Not all questions
addressed OR responses
not clear and focused
(2 points)
Not all
required
questions
addressed. (0
points)
Demonstrates
synthesis of
assigned
readings
Post demonstrates that the
assigned content was
appropriately reviewed,
understood, and synthesized.
Minimal direct quotations.
(points) (6 points)
Demonstrates limited
familiarity and
synthesis of assigned
content. (3 points)
Not all questions
addressed.
Responses do not
demonstrate
synthesis of
assigned readings
(0 points)
Evidence based At least two professional
resources support post.
Resources must be integrated,
Supported by fewer than
two citation/reference
pairs. Or provides
Provides no
scholarly reference
to support
cited, and referenced per APA
style. See criteria for
professional references on p. 9
of syllabus. Rare APA style
errors. (3 pts)
evidence-based, scholarly
references using incorrect
APA format. Or provides
non-scholarly references
with correct APA format
in-text. (1.5 points)
position/ideas in
postings/discussion
and /or uses no
APA format
(0 points)
Writing quality Punctuation, spelling, spacing,
capitalization, and writing
mechanics errors are rare.
Fewer than six total
writing mechanics
Six or more writing
mechanics errors;
run-on sentences.
Writing is clear, succinct,
focused, organized, Easy to
understand main ideas. (2
points)
Writing is focused and
organized. (1 point)
Writing lacks
organization or
focus (0 points)
Posted Posted in both the discussion
forum and the assignment box.
(1 point)
Not posted in both the
discussion forum and the
assignment box (0 points)
Not posted
as directed.
(0 points)
Substantive addition – addition must address the topic/situation other than the topic/ situation
addressed in your original synthesis and application post to earn any points.
Criterion Excellent Competent Not satisfactory
Addition
relevant
and
valuable to
nursing
practice
Substantive addition
demonstrates thorough review
of post. Adds at least one new
perspective that would be
relevant and valuable in nursing
practice situations. (3 points)
Addition accurate,
but application to
nursing practice
limited. (1.5 points)
Relevance to
nursing practice
not included.
(0 points)
Demonstrates
critical analysis
Offered a critical analysis of an
existing posted. Demonstrates
that the assigned content was
appropriately reviewed,
understood, and synthesized.
(3 points)
Addition demonstrates
limited synthesis of
assigned content
related to the
situation/topic. Agreed
or disagreed, but did
not provide
justification. (1.5
points)
Response not
applicable to the
situation/topic.
(0 points)
Supported by
evidence
At least one professional
resource supports post.
Resources must be integrated,
cited, and referenced per APA
style. See criteria for
professional references on p. 9
of syllabus. Rare APA style
errors. (3 pts)
Supported by at least one
citation/reference pair.
Provides evidence-based,
scholarly reference using
incorrect APA format Or
provides non-scholarly
references with fewer
than four APA format
errors. (1.5 points)
Provides no
scholarly reference
to support
position/ideas in
postings/discussion
and /or uses no
APA format (0
points)
writing quality Punctuation, spelling, spacing,
capitalization and writing
mechanics errors are rare.
Writing is clear, succinct,
focused, organized, Easy to
understand main ideas. (1
point)
Fewer than 6 total writing
mechanics
Writing is focused and
organized. (0.5 points)
Six or more writing
mechanics errors;
run-on sentences.
Writing lacks
organization or
focus (0 points)

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