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APHA Scientific Session and Event Listing

Recorded presentation

Jodi Shaefer, PhD, RN, School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Room 438, Baltimore, MD 21205-2110, 410-614-1519, sshaefe1@son.jhmi.edu and Robin Newhouse, PhD, RN, Nursing Administration/School of Nursing, The Johns Hopkins Hospital/University, 600 N, Wolfe St, Billings 220, Baltimore, MD 21287.

Objective: The objectives of this research was to identify major forces that affect rural hospital nursing and to develop an instrument to capture these major domains.

Design: Focus group (11 rural hospital nurse executives), taped phone interview (10 rural hospital nurse executives), instrument development based on content analysis and psychometric testing (20 rural hospital nurse executives).

Results: Content analysis of qualitative data produced three domains: environment, hospital and nursing. Items were developed and survey constructed. Content validity of survey was 1.0 after review by 4 experts after minor revisions. Items with significant test-retest correlations at or above p=.10 and acceptable item-total correlations were included in the final survey. Cronbach's alpha for each domain is as follows; environment [legislative (a=.76) and isolation (a=.91)]; organizational [hospital environment (a=89), quality (a=.76), and quality influences (a=.77)]; and nursing [nursing influences (a=.87) and evidence-based practice (a=.83)]. The resulting instrument consists of 102 questions.

Conclusion: Acceptable estimates of reliability and validity were obtained for a survey that describes unique attributes of the rural hospital nursing environment. This information is essential to understand the effect of legislation on the changes on the delivery of nursing care in rural hospitals.

Learning Objectives:

• 1.Articulate three major forces that have affected rural hospital nursing.
• 2.Discuss unique challenges for nurse executives experienced in the rural hospital.
• 3.Describe research to develop an instrument that captures the major forces that effect rural hospital nursing.

Keywords: Rural Health Care Delivery System, Nurses

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation