Pilot Project award

The Rural Community and Academic Collaborative Pilot Project award was given to 1 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: “Designing and Piloting a Health Equity‐Informed Rural Nursing Obstetric Simulation for Strengthening the Rural Hospital Capacity to Develop Safe and High‐Quality Obstetric Care”

Researchers: Jessica Smith, PhD, MSN, RN, CNE
Kyrah Brown, PhD
Melynda Hutchings, DNP, RN-BC
Jennifer Roye, MSN, RN, CHSE, CNE
Leigh Ann Wheeler, DNP, MSN, RN
Joy Henry, Faith Community Hospital

Description of Project: The purpose of this project is to partner with a rural hospital, Faith Community Hospital (FCH), to assess learning needs and design and pilot a health equity-informed obstetric (OB) simulation-based training program. The short-term goals are to strengthen the relationship between UTA CONHI and FCH and, through simulation-based training, improve rural nurses’ knowledge, confidence, competence, and capacity in providing OB care. The long-term goals are to develop a premier rural OB nursing simulation-based training program, aligned with Center for Rural Health and Nursing (CRHN) goals, to increase the number of rural nurses who are prepared to provide safe, high-quality care for obstetric patients, which is expected to reduce preventable maternal and infant morbidity and mortality. In the long-term, we plan to expand this project to other rural hospitals in Texas, which would bring an innovative, cost-effective, and sustainable continuing education option to the rural nursing workforce directly.

Project’s Importance: In Texas, approximately 89% of maternal deaths are preventable (compared to 60% at the national level). Severe maternal morbidity, such as obstetric hemorrhage, increase risk of maternal death and is associated with prolonged hospitalization after delivery. Research suggests that rural women are at increased risk of SMM and mortality compared to urban women after controlling for clinical and demographic factors. After accounting for rural population size, this increased risk represents an excess of approximately 4,379 cases of SMM and mortality among rural residents who would not have experienced morbidity or mortality had they been living in urban areas. Researchers have identified both clinical factors (e.g., workforce shortages, hospital closures) and social determinants of health (e.g., transportation, housing, racism, poverty, etc.) as significant challenges faced by rural patients. In 2018, 48.6% of Texas counties were maternity care deserts with no birth center, no obstetricians and no hospital offering labor and delivery care. Maternity care deserts, and increasing hospital closures, in rural communities has resulted in a significant shortage of nurses prepared to provide potentially lifesaving emergent obstetric care to rural women. Rural nurses’ preparedness is critical considering the infrequent, and sometimes unpredictable, volumes of OB patients, especially those unable to commute long distances for care at other facilities.

This project will provide simulation-based training, which allows learners to perform and debrief tasks in various real-world scenarios so they will be prepared should the event actually occur. This project will provide an OB simulation-based training, a promising educational innovation, for nurses in this community. This is important because health providers in rural communities tend to have less access to simulation-based training compared to their peers in urban communities.