Factors Influencing RNs' Perceptions of Quality Geriatric Care in Rural Hospitals

Daniel D. Cline, Victoria Vaughan Dickson, Christine Kovner, Marie Boltz, Ann Kolanowski, Elizabeth Capezuti

Research output: Contribution to journalArticlepeer-review


The rapidly aging population and their frequent use of hospital services will create substantial quality challenges in the near future. Redesigning rural hospital work environments is the key to improving the quality of care for older adults. This study explored how the work environment influences registered nurses' (RNs') perceived quality of geriatric care in rural hospitals. We used an exploratory mixed-methods research design emphasizing the qualitative data (in-depth, semi-structured interviews). Quantitative data (questionnaire) measuring the RN work environment were also collected to augment qualitative data. Four themes emerged: (a) collegial RN relationships, (b) poor staffing/utilization, (c) technology benefits/challenges, and (d) RN-physician interactions, which were identified as key factors influencing the quality of geriatric care. We concluded that rural hospital work environments may not be optimized to facilitate the delivery of quality geriatric care. Targeted interventions are needed to improve overall quality of care for hospitalized older adults in rural settings.

Original languageEnglish (US)
Pages (from-to)748-768
Number of pages21
JournalWestern Journal of Nursing Research
Issue number6
StatePublished - Jul 2014


  • acute care
  • gerontology
  • location of care
  • methods
  • nurses
  • nurses as subjects
  • population focus
  • qualitative

ASJC Scopus subject areas

  • General Nursing


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