This blog post was prepared by RNO Website Committee Chair Joan Grant Keltner.

• Over three million individuals who live in rural areas use the Veterans Affairs for their medical care (AARP, 2016). These older individuals are more likely to take multiple medications to manage chronic health conditions. In one study, almost 77% of veteran geriatric patients seen in the Emergency Department had five or more prescription medications, with over 80% taking at least one high-risk medication (Morizio et al., 2021). Unfortunately, taking this number increases the risk for medication errors and can lead to other deleterious side effects, such as falls. In examining useful interventions to improve medication adherence and management, the IMPROVE program used face-to face consultation, with recommendations, education, and other strategies. The IMPROVE program showed a 75% or greater improvement in the timing and dosages of prescribed medications, with a 14% decrease in potentially inappropriate medications. This pharmacist-led program is now available in local and rural Community-based Outpatient Clinics (CBOCs). More information about implementing a Rural Promising Practice is available at www.ruralhealth.va.gov or by email at rural.health.inquiry@va.gov. (Source: https://www.ruralhealth.va.gov/docs/promise/IMPROVE_OnePager_51117.pdf)

Morizio, P. L., Mistry, V., McKnight, A., Pepin, M. J., Bryan, W. E., Owenby, R. K., Previll, L., & Ragsdale, L. C. (2021). Polypharmacy and high-risk medications in older veterans presenting for emergency care. Journal of Geriatric Emergency Medicine, 2(12), Article 3. https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=1007&context=jgem

• Over the last several years, rural physicians have progressively decreased in number while nurse practitioners (NPs) have increased, leaving a pathway for many NPs to meet the healthcare needs of individuals who live in rural areas. About 90% of NPs are certified in primary care, 70% deliver that care, and represent about one out of four rural providers (AANP, 2020, 2022). These statistics indicate NPs provide comprehensive care to rural patients through health promotion and prevention and management of chronic illnesses. Measuring this valuable care that results in positive health outcomes in rural patients is essential to share among ourselves but also with others who have an active voice in advancing our discipline.

AANP (2020, November 19). AANP highlights NP Role in providing accessible rural health care during pandemic. https://www.aanp.org/news-feed/aanp-highlights-np-role-in-providing-accessible-rural-health-care-during-pandemic

AANP (2022). 2022 AANP National Nurse Practitioner Workforce Survey — Preliminary analysis. https://storage.aanp.org/www/documents/NPFacts__111022.pdf?_gl=1*1j7cjqc*_gcl_au*MTYwNzE1MDI4NC4xNjk1MDg1MjY4

This blog post was prepared by RNO Website Committee Chair Joan Grant Keltner.

Below are three programs that will potentially provide essential services, safer living areas, job opportunities, and valuable resources for individuals who live in rural areas.

• The USDA is contributing more than 800 million dollars toward improving rural electric services to connect thousands of individuals in rural areas. Another key service is to provide clean drinking water (e.g., removing steel, lead, and cast-iron service lines), and wastewater systems. These efforts will offer rural employment opportunities for close to 500,000 individuals in 36 states and two U.S. territories. Loans or grants also are available to provide these improvements in low-income communities. (Source: https://www.usda.gov/media/press-releases/2023/08/28/biden-harris-administration-announces-more-800-million-strengthen)

• Starting in 2025, the Medicare Prescription Payment Plan will offer Medicare recipients the ability to make regulated monthly payments for out-of-pocket medications over 12 months (Source: https://www.cms.gov/files/document/medicare-prescription-payment-plan-fact-sheet.pdf).

• The 2026 Medicare Drug Price Negotiation Program will allow Medicare to negotiate prescription prices with drug companies for expensive patented drugs, without substituting generic equivalents. Initially, Medicare has released 10 drugs used to treat kidney and heart disease, diabetes, coronary and peripheral artery disease, rheumatoid arthritis, and others illnesses (Source: https://www.cms.gov/files/document/fact-sheet-medicare-selected-drug-negotiation-list-ipay-2026.pdf).

Just as orthopedic nurses are skilled at caring for the musculoskeletal system, and cardiac nurses specialize in caring for the heart, rural nurses are skilled at knowing a little bit about everything and balancing the needs of their patients with the often limited resources in small and sometimes isolated parts of the country.

With this realization, NRHA is excited to launch its Rural Health Nursing Certification Program! Join us for a webinar about this brand new, multifaceted course designed to equip rural nurses with the information they need and a network of colleagues to help them provide quality care in rural settings while recognizing and celebrating their vast skill sets.

For more information, see below:

Nursing Certification Program Webinar on February 21st at 1 pm EST – register here

Enrollment is open for all Certification Programs for 2023 Cohorts - visit our website for details and application information at www.crhleadership.com

The 2023 election is now closed. Please check back in early 2024 for the next election cycle.

The Call for Nominations is open for the 2023 RNO Election. Please consider nominating a member colleague or yourself. A nominee must be a current RNO member. 

Offices to be filled in 2023:

• President Elect: 1-year, then 2 as President, then 1 year as Past President
• Treasurer: 2-year term
• Member at Large: 3-year term

Please send the nominee’s name, the office, the nominee’s qualifications, and contact information to Adrianne Lane at lanea6@nku.edu by February 28, 2023. If you have questions, please email Adrianne and set up a time to discuss any questions you may have. Do consider this leadership opportunity.  Thank you.