Date of Conferral

4-30-2025

Date of Award

April 2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Miriam Ross

Abstract

Leaders of rural emergency departments (EDs) in the United States face persistent challenges in recruiting and retaining RNs. The aim of this integrative review was to identify strategies to mitigate these challenges. The review question focused on best practices leaders can implement to decrease problems with the recruitment and retention of rural ED nurses. A review of the literature published within the past five years yielded 31 empirical and non-empirical articles, which were analyzed using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) appraisal tool. Overarching themes and subthemes were subsequently identified. The Dynamic Capabilities and Strategic Human Resource Management frameworks provided a theoretical foundation for the study. Five themes and nine sub-themes were identified. The five themes were (a) financial incentives, (b) leadership development, (c) structured mentorship, (d) career development, and (e) policy changes. The nine sub-themes were (a) compensation strategies, (b) competitive salaries, (c) leadership support, (d) leadership engagement, (e) peer networking, (f) professional development, (g) training programs, (h) policy advocacy, and (i) long-term policy reform. This integrative review identified recommendations such as the creation of formal mentorship structures, aligned with the Dynamic Capabilities Framework, as an essential strategy to enhance recruitment and retention in rural EDs. These comprehensive recommendations may help organizational leaders cultivate long-term, high-quality employees who provide essential levels of quality care, yielding positive social change.

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