Top Things to Know: Targeted Nursing Interventions for Improving Stroke Care and Outcomes in the Rural Setting
Published: October 30, 2025
Prepared by Renee Colsch, PhD, RN, SCRN, CQ
- Rural-dwelling populations face higher stroke rates and worse outcomes due to limited access, geographic isolation, and higher rates of uncontrolled risk factors (e.g., hypertension, diabetes, obesity).
- Nurses in rural settings play a central role in stroke prevention, acute care, and rehabilitation, often serving as first responders, educators, coordinators, champions and care leaders.
- Geographic and financial constraints in rural areas limit nurses' access to ongoing stroke-specific training. Innovative education models (e.g., mobile simulations, online learning, gamified training) are critical for skill development.
- Rural hospitals face critical nursing shortages, high burnout, and recruitment challenges, which can decrease stroke care quality. Strategies like epidemiological modeling can help allocate resources and predict staffing needs.
- Having designated stroke coordinators and champions, even part-time, enhances education, protocol implementation, and data tracking. Stroke champions offer a scalable solution for smaller rural facilities.
- Many rural hospitals struggle to participate in stroke quality programs due to low case volumes, resource constraints, and reporting burdens. Some state and national programs provide no-cost tools to overcome these barriers.
- Nurses facilitate cross-disciplinary collaboration, home-based care planning, and smooth transitions from hospital to community, improving long-term stroke recovery outcomes.
- Nurses must adapt care to local rural cultures and communication styles, advocate for needed resources, and address social drivers of health that affect stroke outcomes.
- Despite proven benefits for rapid diagnosis and treatment, telemedicine adoption remains low in rural hospitals due to infrastructure costs and connectivity challenges.
- Artificial Intelligence, mobile health, and advanced data systems can streamline care, enhance decision-making, and personalize post-stroke interventions, provided rural settings receive implementation support.
Citation
Colsch R, Dusenbury W, Camicia M, Leonhardt-Caprio A, King A, Mogos M, Moser R, Patterson J, Vaughn S, Zachrison KS; on behalf of the American Heart Association Stroke Nursing Committee of the Council on Cardiovascular and Stroke Nursing; and the Stroke Council. Targeted nursing interventions for improving stroke care and outcomes in the rural setting: a scientific statement from the American Heart Association. Stroke. Published online October 30, 2025. doi: 10.1161/STR.0000000000000495