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College of Nursing A Collaborative Model for Rural Health Care Education.

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1 College of Nursing A Collaborative Model for Rural Health Care Education

2 College of Nursing A Collaborative Model for Rural Health Care Education Copyright Statement Copyright Michael J. Rice, 2002. This work is the intellectual property of the author. Permission is granted for this material to be shared for non-commercial, educational purposes, provided that this copyright appears on the reproduced materials and notice is given that the copying is by permission of the author. To disseminate otherwise or to republish requires written permission from the author.

3 College of Nursing A Collaborative Model for Rural Health Care Education Michael J. Rice, PhD, ARNP, CS Intercollegiate College of Nursing Washington State University College of Nursing This study was partially supported by grant # D09 HP 00159-02 from HRSA

4 College of Nursing A Collaborative Model for Rural Health Care Education Problem Develop an educational model to address the health care education needs of rural America Must be readily accessible Must be cost effective Must develop self sustaining program

5 College of Nursing A Collaborative Model for Rural Health Care Education Background Goal of Healthy People 2010 is to eliminate health inequalities among different American population groups (USDHHS, 2001) Lower Medicare reimbursement (37.5 percent less) and aging health care facilities reduce access to care in rural communities

6 College of Nursing A Collaborative Model for Rural Health Care Education The land mass of Washington state is greater than 7 states on the eastern seaboard 100,000+ sq. miles population of under two million Wenatchee *Spokane * Yakima *Pullman * Tri-Cities * Washington State

7 College of Nursing A Collaborative Model for Rural Health Care Education Washington State 36 areas in 39 counties are designated as medically underserved 15% of eastern counties have no primary care facilities Only 18 % of all nurses are employed in rural areas Over 25.3 % of all individuals in the rural areas live 200 % the federal poverty level

8 College of Nursing A Collaborative Model for Rural Health Care Education Federally Designated Mental Health Care Shortage Areas Nov 2001

9 College of Nursing A Collaborative Model for Rural Health Care Education Populations Mainly rural population Racially and ethnically diverse populations are growing in Washington Includes migrant and seasonal farm workers, often Hispanic

10 College of Nursing A Collaborative Model for Rural Health Care Education Four major Native American reservations in Washington 1) Colville 2) Spokane 3) Kalispel 4) Yakama Reservations in Idaho 6) Coeur d'Alene 7) Nez Perce

11 College of Nursing A Collaborative Model for Rural Health Care Education Project Objectives To develop systems for rural areas in which IP Videoconferencing can be used to: 1) provide clinical course supervision, 2) provide supervised clinical hours required for the Certification

12 College of Nursing A Collaborative Model for Rural Health Care Education Project Objectives To develop systems for rural areas in which IP Videoconferencing can be used to: 3) facilitate program delivery meeting Washington States requirements for obtaining an ARNP license as a Psychiatric Nurse Practitioner

13 College of Nursing A Collaborative Model for Rural Health Care Education ID Potential 1. Identify existing video communication systems 2. Identify the system goals and activities 3. Identify system movers

14 College of Nursing A Collaborative Model for Rural Health Care Education Assess Capacity Systems Assessment ID Technologies ID Connectivity ID Interface capabilities ID Collaborative potential

15 College of Nursing A Collaborative Model for Rural Health Care Education Collaboration 1) Share Missions May mean expanding your mission 2) Share Equipment Technicians and costs 3) Share Sites

16 College of Nursing A Collaborative Model for Rural Health Care Education 4) Share Personnel 5) Interagency collaboration Multilevel mergers of visions and activities

17 College of Nursing A Collaborative Model for Rural Health Care Education Use of Lay and professional Medical Psychiatric Support groups (LAMPS) as advisory groups Five throughout Washington Outcomes

18 College of Nursing A Collaborative Model for Rural Health Care Education a Merger of Washington Higher Education Television Systems (WHETS) with ISDN and internet protocols (IP) for course delivery Gateways and Bridges Live video streaming options

19 College of Nursing A Collaborative Model for Rural Health Care Education b c WSU Computer Center and Archived Files Information Technology Department and IP systems

20 College of Nursing A Collaborative Model for Rural Health Care Education d Collaboration of WSU Cooperative Extension and College of Nursing Share Sites via merger with WECAN Share Personnel Share Equipment – begin standardizing Share Recruitment

21 College of Nursing A Collaborative Model for Rural Health Care Education Inland Northwest Telehealth Bridge to Whets for programs Bridge to Hospitals Bridge to Videoconference e

22 College of Nursing A Collaborative Model for Rural Health Care Education Evaluation Evaluate outcomes using modified Current Student Inventory based on the Flashlight Project and Government Performance and Results Act (GPRA) of 1993 and P.L. 105-392, Subtitle B, the Nursing Education and Practice Improvement Act of 1998

23 College of Nursing A Collaborative Model for Rural Health Care Education Connectivity A Core Courses Video streamed live to any household in Washington State Archived for rural students who are working Logged through Blackboard

24 College of Nursing A Collaborative Model for Rural Health Care Education Connectivity B Clinical Courses 6 College of Nursing Sites 18 WECAN Sites (+) 89 Telehealth sites in hospitals 104 Total locations

25 College of Nursing A Collaborative Model for Rural Health Care Education Students C Enrollments up 900% 118% over projections Tuition exceeds $550,000 this year Turning away candidates

26 College of Nursing A Collaborative Model for Rural Health Care Education Students

27 College of Nursing A Collaborative Model for Rural Health Care Education Demographics N=57 Mean age of 40-49 years- range of 20 to 59 years female (86%) male (10%)

28 College of Nursing A Collaborative Model for Rural Health Care Education Demographics Hispanic = 3.9% Native American = 3.9% African American = 2 % Asian = 2% Caucasian = 88%

29 College of Nursing A Collaborative Model for Rural Health Care Education 0 - 5 miles: 3.3% 6 - 10 miles: 10.0% 11 - 20 miles: 3.3% 21 - 50 miles: 3.3% 51 - 100 miles: 10.0% >100 miles: 70.0% Distance from main campus

30 College of Nursing A Collaborative Model for Rural Health Care Education Location Remote campus 60.0% Main campus 26.7% Rural hospital site 3.3% Distance Learning site: 10.0% Location

31 College of Nursing A Collaborative Model for Rural Health Care Education …able to take course via interactive teleconference…. Strongly agree 53.3% Not applicable 20.0% Disagree10.0% Agree 13.3% Strongly disagree3.3%

32 College of Nursing A Collaborative Model for Rural Health Care Education Student cost per week Frequency%Valid %Cumulative % $ 0310.0 $ 1-51136.7 46.7 $ 6-10930.0 76.7 $11-1613.3 80.0 $17-25413.3 93.3 $26-3213.3 96.7 $33-4013.3 100.0 Total30100.0

33 College of Nursing A Collaborative Model for Rural Health Care Education …able to juggle my course work and home responsibilities…. Much less likely 4.3% Much more likely 60.9% Somewhat likely 17.4% About the same17.4%

34 College of Nursing A Collaborative Model for Rural Health Care Education …spend more time studying…. Much more likely 43.5% Much less likely 4.3% Somewhat likely 34.8% About the same17.4%

35 College of Nursing A Collaborative Model for Rural Health Care Education How many hours do you work for pay? 40+ hrs/week 26.1% 32-40 hrs/week 26.1% 0 hrs/week or no response 26.1% 1-15 hrs/week 4.3% 16-23 hrs/week 8.7% 24-31 hrs/week 13.0%

36 College of Nursing A Collaborative Model for Rural Health Care Education ICN-Mira network was appropriate Strongly agree 52.2% Agree 43.5% Disagree 4.3%

37 College of Nursing A Collaborative Model for Rural Health Care Education …spent less time traveling to and from campus…. Strongly agree 43.5% Not applicable 4.3% Disagree 17.4% Agree 34.8%

38 College of Nursing A Collaborative Model for Rural Health Care Education 90% located in rural and medically underserved areas Practice locations include: Migrant clinics Community mental health centers Prisons Underserved areas Graduates

39 College of Nursing A Collaborative Model for Rural Health Care Education Summary MIRA Model benefits rural students place bound by jobs, geographical barriers and family obligations MIRA Model for collaborative use of technologies can address and solve the rural health care needs of presently medically underserved areas

40 College of Nursing A Collaborative Model for Rural Health Care Education Linkage to regional educational settings provides an invaluable service in small remote communities with limited communications infrastructure

41 College of Nursing A Collaborative Model for Rural Health Care Education Recruitment and retention can be overcome in rural and remote communities using IP teleconferencing connections

42 College of Nursing A Collaborative Model for Rural Health Care Education The ICN MIRA Network enabled direct teaching in a synchronous, real time mode to isolated communities

43 College of Nursing A Collaborative Model for Rural Health Care Education The use of IP based Telehealth provides an avenue for solving the problem of lack of access by providing care and clinical sites for rural individuals

44 College of Nursing A Collaborative Model for Rural Health Care Education Michael Rice, PhD, ARNP, CS ricem@wsu.edu (509) 324.7256 Washington State University College of Nursing Vancouver, WA Campus


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