1. Mosca, Laura BSN, RN, CEN

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Gail M. Pfeifer's "Finding Solutions to Advance Rural Health" (In the News, September) concludes by mentioning a key component: collaboration. Indisputably, one of the major hardships of rural nursing is a lack of resources. Building collaborative relationships is imperative if we are to improve patient care and have better patient outcomes.


The importance of collaboration became clear during my recent work as a consultant and project process owner with a rural facility's program to improve inpatient hyperglycemia care. The chief nursing officer collaborated with a pharmaceutical company sponsoring a glycemic health initiative, which gave the hospital the free assistance it needed to get the project off the ground. An interdepartmental and interdisciplinary methodology required the involvement of those in the pharmacy, laboratory services, admissions, dietary, and information technology departments, among others. Realizing there were insufficient resources for long-term sustainability of the initiative at the hospital, the chief nursing officer reached out to community-based diabetes educators and home health nurses. A new, evidence-based protocol was created, an education plan was developed, and compliance parameters were fixed.


Ultimately, by using an innovative approach and collaborative relationship building, this rural facility has changed the face of hyperglycemia care in its community.


Laura Mosca, BSN, RN, CEN


Oklahoma City, OK