While the United States (U.S.) healthcare system has been extremely successful, concerns remain about access to care for a large segment of the population (Rivers, 2003). Availability o f health care to rural areas is limited, leaving a large portion of the American population with limited access to care. According to the data of the U.S. Census Bureau collected in 2001 27% of the United States population was considered rural. Rural, as defined by the Census Bureau, is a town of less than 2,500 residents’ (Schmidt, 2005). Nurse Practitioners (NPs) can offer increased accessibility to local care by addressing primary needs in rural health while providing routine health and illness care. N P’s can effectively provide primary care in the rural setting (Wiken, 2004). The purpose of this study was to explore the literature regarding rural health and access to care. A systemic review o f the literature using a computer search o f CINAHL, MEDLINE, and Cochrane Library identified a need for further knowledge in nursing regarding the relationship between rural health and access to care. 140 indexed citations whose titles included “rural health and access to care and nurse practitioner” were reviewed. O f these, 35 articles were initially selected. However, only 25 of the citations reviewed were found to be applicable to this research study. For the purpose of this investigation, the relationship between rural health and access to care was explored using an evidenced-based, systemic, literature review. Orlando’s Deliberative Nursing Process model was selected to form the theoretical foundation for the purposes of this study. Orlando’s model is considered a grand theory categorized as a nursing process theory encompassing nursing theory, practice, education and administration (Peterson, 2004). The following research questions were generated regarding rural health and access to care: (a) what is the role of the NP as it relates to rural health care, and (b) How doe the NP impact access to care in rural setting? Information gained from this study will add to the current nursing knowledgebase on rural health and access to care and will assist NPs in planning cost-effective, quality care and appropriate education for the rural dwelling population.


Master of Science in Nursing (MSN)


Graduate Nursing

Degree Date


Publication Number


First Advisor

Dr. Brenda Smith

Second Advisor

Dr. Rebecca Cagle

Third Advisor

Dr. Mary Patricia Curtis

Document Type


Included in

Nursing Commons