Staff In Rural Hospitals Research Articles

Impact of TeamSTEPPS Training With Rural Hospital Staff: A Quality Improvement Project.

Teamwork and communication are critical components to patient safety and reducing clinical errors. TeamSTEPPS is a successful team-training program evaluated by many health care settings; however, there are limited data on its use in small, rural hospitals. A large health care system purchased a small, rural hospital with the goal to improve patient care by creating a team-based culture and a financially stable organization. This quality improvement project used a pre-/postdesign to evaluate the staff's knowledge, application, and attitudes toward team skills and behaviors. The intervention was a customized TeamSTEPPS training program delivered to an interprofessional team at a small rural hospital. The interprofessional staff demonstrated improved attitudes toward team behaviors and incorporated the tools into their practice. TeamSTEPPS is an effective program for training a variety of health care disciplines.

Strategies to Enhance Knowledge and Practical Skills of Triage amongst Nurses Working in the Emergency Departments of Rural Hospitals in South Africa.

Purpose: Lack of knowledge and practical skills on triage remains a global problem, especially within rural hospitals, and very little is known about enhancing the knowledge and skills of emergency nursing staff in rural hospitals of South Africa. The objective was to describe the perceived strategies for enhancing knowledge and practices of triage among nurses working in the emergency departments (EDs) of rural hospitals in South Africa. Research methods: A descriptive qualitative research design was applied to achieve the research objective. A non-probability sampling method was applied to select 17 professional nurses from rural hospitals. An unstructured face-to-face interview method was used to collect data. Data collected were analyzed using Tesch’s method of data analysis. Results: The study findings highlighted the academic needs of nurses working in the ED of rural hospitals. Two themes emerged from this study; (1) The consistent description of the importance of triage training for emergency unit staff, and (2) The description of measures to enhance triage practices amongst emergency unit staff. Findings indicated that triage knowledge and practice remains a challenge, but with formulated strategies like continuous training by workshops, refresher courses, and offering a training module on triage, evaluation of developed guidelines and benchmarks is often enhanced. Conclusions: The study describes the strategies to enhance the conversion of knowledge and practice of triage amongst nurses working in the ED of rural hospitals. The paper argues that the knowledge and practical skills of nurses working in ED are enhanced through the provision of continuous training as workshops, triage module, evaluating the developed guidelines to implement triage, and benchmarking with other hospitals.

The Wakayama-Immediate Stroke Life Support Course: Achieving Successful Training on the Stroke Emergency System without using Mechanical Medical Training Simulators.

Background:The Immediate Stroke Life Support (ISLS) course run in Wakayama (Wakayama-ISLS course) is an off-the-job training course for understanding the initial treatment of acute stroke. A total of 22 Wakayama-ISLS courses have been held in Wakayama Prefecture since 2008. To begin with, the case presentation was performed using human-like, mechanical manikins for simulation training. However, as the course progressed, we found the students paying great attention to the display monitor, and less to the patients' neurological status.Methods:From the fourth Wakayama-ISLS course onward, we conducted the group work with the facilitators pretending to be patients, i.e., without medical training manikins.Results:When the facilitators acted as patients, the students gained a more realistic and expressive perception of neurological symptoms. As a result, they expressed a high level of satisfaction with the course in the questionnaire sent immediately afterwards, regardless of their profession or prior experience. Moreover, as we did not need to transfer medical training simulators, we were able to carry out three ISLS courses at locations some distance from Wakayama city on a low-cost basis. This also enabled the regional medical staff in rural hospitals to participate in the courses easily.Conclusion:The Wakayama-ISLS course without medical training manikins is an entirely feasible off-the-job training course, which provides training on fast and excellent treatment of acute stroke problems based on clinical practice. The course has the potential to spread not only across Japan but throughout the world, including to developing countries, given the cost perspective.

Overcoming the challenge of COVID-19: A grounded theory approach to rural nurses' experiences.

IntroductionThis study inquires into nurses' changing perceptions with regard to the efforts in preparation for working in a COVID‐19 ward in the rural Japanese context.MethodsData were collected using ethnographic methods and semi‐structured interviews among 16 nurses working in the COVID‐19 ward of a rural community hospital in Japan. A grounded theory approach was used for the qualitative analysis.ResultsIn total, 70 hours' observation and participation were completed, and 27 pages of field notes were taken and used for the analysis. In addition, 32 interviews were conducted with 16 participants. Four themes emerged from the data: pre–COVID‐work perceptions, overcoming fear, shadow cast by working in the COVID‐19 ward, and an integrated approach to the fear of COVID‐19. The nurses initially felt unpredictable fear. However, the establishment of standard approaches and practices for COVID‐19 gave them confidence in their safety and helped them regain sympathy for patients. Nevertheless, working on COVID‐19 cases negatively affected their activities outside of the ward, and some of them developed an identity crisis as they feared for the future.ConclusionBetter teamwork, comprehensive understanding of COVID‐19, and continuous provision of proper knowledge in rural hospitals should be driven by appropriate understanding and sympathy for nurses and patients in COVID‐19 wards. The results of this study can be applied to mitigate nurses' fear, improve teamwork, and ensure understanding of COVID‐19 by all medical staff in rural hospitals.

Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits

This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation. We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n=6), physicians (n=3), nurses (n=9), respiratory therapists (n=5) and other (n=1) from July 2011 to May 2013. Transcripts were analysed for thematic content. Overall, rural ICU staff viewed Tele-ICU as a welcome benefit for their facility. Major themes included: (1) beneficial where recruitment and retention of staff can be challenging; (2) extra support for day shifts and evening, night and weekend shifts; (3) reduction in the number of transfers larger tertiary hospitals in the community; (4) improvement in standardisation of care; and (5) organisational culture of rural ICUs may lead to under-utilisation. ICU staff at rural facilities view Tele-ICU as a positive, useful tool to provide extra support and assistance. However, more research is needed regarding organisational culture to maximise the potential benefits of Tele-ICU in rural hospitals.

Predictors of Work Stress among Psychiatric Nursing Staff in Rural and Urban Settings in Taiwan

<p>Aim: The aim of this study was to compare the work stress of nursing staff in urban and rural areas of Taiwan and to explore the predictors of work stress in nurses in Taiwan.<br />Method: In this cross-sectional study, purposive sampling was adopted to select 271 nursing staff members from 2 psychiatric teaching hospitals. The Emotional Quotient Inventory (Sun, 2004) and the Nurse Stress Checklist (Tsai & Chen, 1996) were used to perform this study. A hierarchical multivariate regression model was used to examine significant predictors of work stress.<br />Results: The work stress of nursing staff in urban hospitals was lower than that of nursing staff in rural hospitals. Compared with the urban nursing staff who participated in the EQ and stress classes, the rural nursing staff, regardless of whether they had attended the classes, experienced more work stress; and hospital types, employment patterns, years of work experience, and emotional intelligence were predictors of work stress. <br />Conclusion: Overall, the findings demonstrate that administration managers must provide effective career advancement measures (eg, offering full-time jobs) or increase salaries to recruit sufficient nursing staff. In addition, managers could avoid unfair treatment experienced by part-time nursing staff by placing additional emphasis on the basic welfares and salaries of nursing staff to effectively mitigate the stress that they experience.</p>

Delivering Rural Health in a Changing Health Model

An exploratory examination of rural hospital staff experiences to determine whether the physical state of rural healthcare facilities influence the healthcare experience and perception of care quality. Rural hospitals have served as the backbone of rural communities in the United States. Over time, these facilities have witnessed enhanced expectations, expanding their scope of operations from acute care to diversified services through linked provider networks and disaster management. Simultaneously, financial challenges, increasing emphasis on safety and quality, and the Affordable Care Act have introduced new challenges for rural hospitals. Currently, there is little empirical knowledge in this domain from a facility perspective. An exploratory qualitative study was conducted, involving semistructured interviews of upper and mid-level administrators in four rural hospitals located in West Texas. All questions attempted to obtain the subject's knowledge, ideas, and opinions concerning the physical design of the hospitals and the hospital experience. According to data on staff experiences, two classes of factors surfaced as potential influencers of hospital experience and care quality: (1) care configuration and (2) outdated building. Care configuration pertains to positioning facilities designed with inpatient care focus to a market expanding in outpatient services. Outdated buildings affect several issue including perceived provider quality and spatial accommodations for safe/efficient care and thereby also affecting the healthcare experience. Physical infrastructure of rural hospitals may have important and meaningful implications for population health performance in rural America.

Rural Hospital Web-Based, Evidence-Based Practice Professional Development

To provide quality patient care and achieve positive patient outcomes, it is widely recognized that organizations must develop a supportive environment that encourages individuals to practice from a research- and evidence-based framework. This article describes a Web-based professional educational program designed to teach principles of evidence-based practice to nurses in rural hospitals. Nurses working in staff development will find this useful for designing educational programs for staff in rural hospitals.

Hold That TIGER! A Collaborative Service-Learning Academic-Practice Partnership With Rural Healthcare Facilities

Observing a renewed focus on community engagement as part of our university's strategic plan and the experiential learning partnerships encouraged by the TIGER (Technology and Information Guiding Education Reform) Initiative in health information technology, an academic-practice partnership was initiated between a group of Midwestern rural hospitals and a university's advanced practice nursing students via the graduate online nursing informatics course. Using a service-learning approach, the course features an emphasis on the collaborative design and implementation of student- and healthcare provider team-driven projects to support rural hospital staff and administrators in meeting the broad spectrum of challenges they face every day. The author discusses the adaptable course outline of foundational and service-learning course activities, recent service-learning projects and outcomes, and results of a cumulative 2-year course evaluation by internal/external stakeholders.

Pandemic influenza vaccination: Will the health care system take its own medicine?

To identify factors associated with acceptance of the pandemic Influenza A H1N1 California 7/09 vaccine (pH1N1 vaccine) in rural hospital staff. Cross-sectional group administered survey. A 58-bed rural Queensland hospital, over a 10-day period starting five days after commencement of the pH1N1 vaccination program. Hospital staff and students. Intention to receive pandemic influenza vaccination, seasonal influenza vaccination. The survey was completed by 252 staff and students (full response rate 76.1%, cooperation rate 98.4%). The majority of respondents had already decided whether or not to receive the pH1N1 vaccine: 111 (44.0%) intended to be vaccinated, 63 (25.0%) intended not to be vaccinated and 78 (31.0%) were undecided. Of 125 staff who had received the seasonal influenza vaccine, 86 (68.8%) intended to receive the pandemic vaccine. Respondents were less likely to state acceptance of the pH1N1 vaccine if they identified concern about vaccine adverse reactions (odds ratio (OR) 0.29; 95% confidence interval (CI), 0.11-0.78), vaccine safety (OR 0.20; 95% CI, 0.09-0.46), vaccine efficacy (OR 0.20; 95% CI, 0.04-0.87) or perceived limitations of vaccine trials (OR 0.08; 95% CI, 0.01-0.99) as primary reasons discouraging pandemic influenza vaccination. There is considerable concern among rural hospital staff regarding pH1N1 vaccine adverse reactions, safety, efficacy and the adequacy of clinical trials on its use. Education specifically addressing these concerns might increase pandemic vaccine acceptability.

Collaborating with Public Libraries, Public Health Departments, and Rural Hospitals to Provide Consumer Health Information Services

ABSTRACT East Tennessee State University Quillen College of Medicine Library (ETSUQCOML) developed a training program to enable public libraries, public health workers, and rural hospital staff to be consumer health information providers. Four NN/LM-developed classes were taught to public libraries. Regional public library directors were invaluable in obtaining the concurrence of their boards for release time for class attendance. Classes were also developed for the public health workforce and rural hospital staff. Five-hundred thirty-three students attended the classes. Fifty-two public library workers will receive the MLA's Consumer Health Information Specialist certification. Thirty-one public libraries have joined NN/LM. All ordered MedlinePlus marketing materials for their libraries from InformationRx. org.