Many Australians who live in rural and remote areas face poorer health outcomes because geographical isolation, lack of resources, and staff shortages limit access to healthcare. This makes it even more imperative to ensure up-to-date, evidence-based procedures and clinical decision support are available to healthcare workers in isolated locations so nurses can deliver high-quality, patient-centred care.
According to the Australian College of Nursing, nurses are the largest group of health providers in the rural and remote workforce, with many communities dependent on nurse-led services. The National Rural Health Alliance, which advocates for the 7 million people in rural Australia (or 28% of Australians), suggests that limited access to health services is a disincentive to live in regional areas.
Non-urban healthcare professionals may experience extra barriers to delivering best practice to their patients. Geographical isolation — exacerbated in Australia by vast distances — reduces access to professional development, peer support, and supervision. At the same time, they are often required to have a broader range of clinical skills and knowledge due to the array of patients' needs and lack of other staff.
Nurses are also an integral part of the Royal Flying Doctor Service (RFDS), which offers a lifeline to Australians living in the bush, providing primary healthcare and emergency retrieval services to about 300,000 patients a year.
The RFDS' Best for the Bush report from 2022 highlights that:
- Residents of rural and remote areas experience higher rates of ill health and potentially preventable hospitalisations compared to city dwellers
- Women in very remote areas are likely to die 19 years earlier, and men 13.9 years earlier, than their counterparts in major cities
- More than 44,000 people in remote regions do not have any access to a primary healthcare service within a 60-minute drive
Level the playing field with evidence-based practice
Wolters Kluwer Chief Nurse Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, shared in a video that the main challenge in healthcare was to provide the evidence-based, cost-effective, quality care that would improve patient outcomes.
“Evidence-based practice is combining the best research evidence with clinical expertise and patient preference,” she said. “We know that using evidence-based practice pretty much levels the playing field across the world of how care is delivered and the type of outcomes you would expect.”
Strategies to underpin better rural care
There are a variety of policies and programs aimed at combatting the rural health disadvantage and providing an environment and workforce that supports best practice everywhere. These include strategies that focus on technology, new models of care, and training pathways.
Telehealth is one way to improve healthcare access and overcome staff shortages in isolated areas, and in particular in Aboriginal communities, where many prefer to stay in the country. A 2023 article found telehealth could improve healthcare access in remote areas if complemented with sufficient face-to-face services. The challenge is ensuring good digital infrastructure and solid, affordable internet connections, plus proper training of Aboriginal staff to ensure a “culturally safe clinical environment.”
Innovative models of care
National Rural Health Alliance Deputy Chair Stephen Gourley told a conference in 2022 that rural and remote communities required different models of care and funding than their urban counterparts. The Alliance recommended a Primary Care Rural Integrated Multidisciplinary Health Services (PRIM-HS) model, which would introduce local health hubs tailored to the unique needs of rural communities. These aim to overcome barriers to attracting and retaining a health workforce to a country practice and improve access to quality, culturally safe healthcare.
Training the workforce
The Federal government's Stronger Rural Health Strategy aims to deliver 3,000 additional physicians and 3,000 extra nurses by 2028. There are also a range of scholarships, higher education and training programs, and placements on offer to support nurses working in rural and remote settings, as well as opportunities to encourage more experienced nurses to become nurse practitioners (NPs). Studies have shown that NPs can not only improve access to services and reduce waiting times but also deliver the same quality of care as doctors for a range of patients. In Western Australia, a pilot program will fund up to 20 NPs to support the delivery of care to underserved populations, including regional and remote areas.
There are unique challenges in providing health services across Australia to ensure quality care no matter where people live. This includes mitigating the barriers that rural and remote communities face to improve the health of their populations. For nurses working in these complex and isolated settings, there is an increased need to demonstrate advanced practice skills and integrate evidence-based practice, which is known to facilitate the highest quality care and patient outcomes.
Learn more about how Lippincott® Solutions Australia supports evidence-based practice across all healthcare settings.