Academic Community Partnership (ACPP) Award
The Rural Community and Academic Collaborative Pilot Project award was given to 2 group recipients for the 2022-2023 award year. This research initiative focuses on supporting faculty of the College of Nursing and Health Innovation (CONHI) in research endeavors and partnerships in rural communities focused on rural health nursing education.
RESEARCH PROJECT #1
Title: “Improving Well-Being and Mindfulness in Nurses Working in Rural Hospital Settings: A Quasi-Experimental Study”
Researchers: Regina Urban, PhD, RN, NPD-BC, CNE, MA-LPC
Sheree Henson, PhD, RN, NEA-BC – System Director Nursing Professional Practice at Texas Health Resources
Description of Project: This project promotes resilience in nurses working in two hospitals in rural settings, Texas Health Kaufman, and Texas Health Stephenville using well-being and mindfulness training. Texas Health employees will be trained to teach the well-being and mindfulness program. Promoting nurse wellness also helps improve the practice environment’s health and retention of nurses. County Names: Erath and Kaufman.
The counties of Kaufman and Erath house Texas Health Kaufman and Texas Health Stephenville, respectively. Each hospital serves a population of less than 50,000, which meets the rural definition according to the Texas Department of Agriculture. The communities are greater than 60% white followed by Hispanic and Black. The poverty percentage of these communities is between 14-39%. These rural hospitals provide acute care and are all Level IV Trauma Centers. Texas Health Stephenville has 98 beds, and Texas Health Kaufman has 91 beds. Texas Health Stephenville employs 128 RNs. Registered nurse demographics are similar to the population of the community with 88.3% white followed by Hispanic and Black. Texas Health Kaufman employees 66 RNs with 85.3% white followed by Hispanic and Black.
Project’s Importance: The drastic change in patient acuity, increased use of personal protective equipment, and decrease in nursing staff resulted in Texas Health Kaufmann RN retention rate dropping from 94.1% in 2020 to 82.1% in 2022 with a current vacancy rate of 7.87. Texas Health Stephenville faced an all-time high vacancy rate of 15.02% at the beginning of 2022 and their retention rate dropped to 88.7% in 2020. Many nurses resigned to find less stressful nursing jobs, but many left the profession. Nurses in the Emergency and Critical Care settings for both hospitals report experiencing continued trauma from patient death, fear, and loss of team during the pandemic. Rural communities have a small candidate pool, elevating the need to retain qualified nurses. Providing the nurses with tools designed to decrease stress and improve well-being is a vital key to retention.
RESEARCH PROJECT #2
Title: “Development and Pilot Test of the Rural Veteran Suicide Assessment – Virtual Reality (VET-SAVR-R) Training Simulation”
Researchers: Donna Schuman, PhD, LCSW
SuLynn Mester, DNP, MSN, RHCNOC, RN
Joaquin Romero, MSW – COO of One Tribe Foundation
Description of Project:
A. Test recognition of warning signs of an impending suicidal crisis in a rural veteran by nursing students, rural veteran experts (i.e., nurses and mental health clinicians currently serving rural veterans), and nonprofessional gatekeepers (anyone strategically positioned to recognize and refer a veteran at risk of suicide, e.g., parents, friends, neighbors, peers; measure: number of warning signs identified).
B. Assess user ratings of sense of physical space (immersion), engagement, ecological validity, and negative effects to determine presence, acceptability, and usability.
C. Compare pre-post knowledge about suicide and lethal means restriction, self-efficacy (comfort and confidence in discussing lethal means restriction), and counseling intention by group (expert, student, nonprofessional gatekeeper) to determine preliminary effectiveness.
Project’s Importance: Lethal means reduction is an evidence-based strategy for suicide prevention and one of the few population-based strategies shown to decrease suicide rates. Putting time and space between the impulse to die and the means to carry it out saves lives because most suicide-related crises last less than a few hours. In one study, 47% said less than one hour elapsed between their decision to attempt suicide and the actual attempt. Thus, partnering with veterans and those close to them ahead of time to help them survive a suicidal crisis can likely prevent them from dying by suicide. Ultimately, successful identification of warning signs can help combat suicidal ideation by recognizing that the veteran is in crisis and needs immediate intervention.
In addition to its importance to direct service providers, virtual reality lethal means training for gatekeepers can be a critical tool in suicide prevention efforts for the rural veteran community. Gatekeepers are individuals who may meet veterans and be able to identify warning signs of suicide risk and provide support and resources. In addition to healthcare providers, these may include family members, friends, social workers, clergy, and others. By providing virtual reality lethal means training to gatekeepers, we can increase their knowledge and skills in identifying and responding to suicide risk and provide them with the tools and resources necessary to
prevent suicides in the rural Veteran community. In addition, virtual reality can be used as a tool to educate gatekeepers on creating safety plans with veterans. The Safety planning intervention (SPI) is an evidence-based intervention tool utilized to mitigate the risk of suicide that includes lethal means assessment and risk mitigation. However prior work in this area indicates that although the safety plan serves as a guide for veterans in crisis, most gatekeepers are not trained in its use.
Moreover, virtual reality lethal means training (as opposed to in-person training) can be an effective way to overcome some of the barriers that may prevent gatekeepers from receiving traditional training. Rural areas may have limited access to mental health services and training programs, making it difficult for gatekeepers to receive the training they need. Virtual reality training can help to overcome these barriers by providing a flexible and accessible training option that can be completed at any time, from anywhere with an internet connection. By increasing access to training and providing gatekeepers with the tools and resources they need to prevent suicide among the rural veteran community, virtual reality lethal means training can play an important role in supporting the mental health and well-being of veterans and their families in Texas.