Strengthening Rural Health Care

A Scoping Review of Nurse Recruitment and Retention Strategies

Bibliographic Data

ID9105075
AuthorsKelley Arredondo (0000-0001-6657-3379, Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, corresponding author), Laura Witte (0000-0002-7247-3902, Veterans Affairs, South Texas Veterans Health Care System, San Antonio, TX), Alexander Paterson-Roberts (0009-0006-7296-9154, University of Houston), Alexandra Caloudas (Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, corresponding author), Matthew Vincenti (VHA Office of Rural Health’s Veterans Resource Center in White River Junction, White River Junction, VT), Matthew P Vincenti (Dartmouth College, corresponding author), Bradley V Watts (0000-0003-2397-6359, VHA Office of Rural Health’s Veterans Resource Center in White River Junction, White River Junction, VT), Bronwyn Sutherland (Texas Medical Center Library, Houston, TX), Hilary Touchett (0000-0001-5840-0574, Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, corresponding author)
Year2026
Volume64
Issue1S
PagesS18-S25
Publication date2026-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002202
PMID41359985
OpenAlexW4417137325
LanguageEN
Citations received1
References cited26

BACKGROUND: Despite nursing being the largest US health profession, only 16% of registered nurses (RNs) practice in rural areas, where health care access is limited. This significantly impacts rural residents, including over 2.7 million rural veterans receiving care at the Veterans Health Administration, leading to compromised health outcomes. Nurses are vital in primary care, improving coordination and management of chronic conditions. OBJECTIVES: Identify recruitment and retention programs for rural nurses (licensed vocational nurses/licensed practical nurses and RNs), including strategy characteristics and location. RESEARCH DESIGN: We conducted a scoping review of published and gray literature. Eligible studies targeted US rural nurse recruitment and retention strategies. MEASURES: Data were extracted for program characteristics, including strategy type (eg, financial incentive), focus (recruitment, retention, or both), and collaboration levels (single or multi-institutional). RESULTS: Of 1179 unique articles identified, only 60 met the inclusion criteria. An additional 42 programs were identified from gray literature, totaling 102 programs. Twenty-two programs used a multipronged approach (2-14 strategies), totaling 180 strategies. Education (n=85) and personal and professional support (n=54) were the most frequently used recruitment and retention strategies. CONCLUSIONS: Of the 102 programs, only 22 used a multipronged approach, with education as the most frequently used strategy. More programs should use a multipronged approach and provide additional incentives and support (eg, financial incentives) to rural nurses beyond education. Only 4 strategies were regulatory, shedding light on the need for more nurse recruitment and retention support at the policy level

Health care · Incentive · MEDLINE · Program evaluation · Rural area · Rural health · Global Health Workforce Issues · Nursing Education, Practice, and Leadership · Nursing Roles and Practices · Health Policy