Hospital-based emergency nursing in rural settings.

In 2006, the Institute of Medicine (IOM) released a series of reports that highlighted the urgent need for improvements in the nation's emergency health services. This news has provided new energy to a growing body of research about the development and implementation of best practices in emergency care. Despite evidence of geographical disparities in health services, relatively little attention has been focused on rural emergency services to identify environmental differences. The purpose of this chapter is to summarize the contributions of nursing research to the rural emergency services literature. The research resembles a so-called shotgun effect as the exploratory and interventional studies cover a wide range of topics without consistency or justification. Emergency nursing research has been conducted primarily in urban settings, with small samples and insufficient methodological rigor. This chapter will discuss the limitations of the research and set forth an agenda of critical topics that need to be explored related to emergency nursing in rural settings.