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[PMID]:29446902
[Au] Autor:Pontious JM
[Ti] Título:Turning out the lights for Rural Medicine.
[So] Source:J Okla State Med Assoc;109(6):175, 2016 06.
[Is] ISSN:0030-1876
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Orçamentos
Fechamento de Instituições de Saúde
Hospitais Rurais
Serviços de Saúde Rural
[Mh] Termos MeSH secundário: Hospitais Rurais/economia
Seres Humanos
Oklahoma
Serviços de Saúde Rural/economia
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE


  2 / 4373 MEDLINE  
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[PMID]:29461350
[Au] Autor:Nelson-Brantley HV; Ford DJ; Miller KL; Stegenga KA; Lee RH; Bott MJ
[Ad] Endereço:Author Affiliations: Assistant Professor (Dr Nelson-Brantley), Professor and Former Dean (Dr Miller), Adjunct Clinical Assistant Professor (Dr Stegenga), Associate Professor and Associate Dean for Research (Dr Bott), University of Kansas School of Nursing; Associate Professor (Dr Ford), Interdisciplinary Leadership Doctoral Program, Creighton University; Professor and Chair (Dr Lee), Health Policy and Management Department, University of Kansas Medical Center.
[Ti] Título:Leading Change: A Case Study of the First Independent Critical-Access Hospital to Achieve Magnet® Designation.
[So] Source:J Nurs Adm;48(3):141-148, 2018 Mar.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®. BACKGROUND: Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. METHODS: Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed. Observations of hospital units and administrative meetings were done, and hospital reports were analyzed. RESULTS: Nine themes emerged to support a conceptual model of leading change. The CAH spent 3 years of its 6-year journey establishing organizational readiness. Nurses overcame complex challenges by balancing operational support and fostering relationships. The Magnet journey led to significantly improved nurse and patient outcomes. A new organizational culture centered on shared governance, evidence-based practice, and higher education emerged. CONCLUSIONS: The journey to Magnet leads to improved nurse, patient, and organization outcomes.
[Mh] Termos MeSH primário: Hospitais Rurais/organização & administração
Enfermeiras Administradoras/organização & administração
Recursos Humanos de Enfermagem no Hospital/organização & administração
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Hospitais Rurais/recursos humanos
Hospitais Rurais/normas
Seres Humanos
Relações Interprofissionais
Liderança
Enfermeiras Administradoras/normas
Recursos Humanos de Enfermagem no Hospital/normas
Estudos de Casos Organizacionais
Cultura Organizacional
Inovação Organizacional
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000588


  3 / 4373 MEDLINE  
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[PMID]:29461348
[Au] Autor:Courtney P; Parnell L; Hayden M; Johnson C; Phillips T
[Ad] Endereço:Author Affiliations: Director (Ms Courtney), Cardiac Telemetry Unit; Director (Ms Hayden), Education Department; Director (Dr Parnell), Maternal Child Services; Charge Nurse (Ms Johnson), Pulmonary/Telemetry Unit; Nurse Researcher (Dr Phillips), Nursing and Institutional Research, Baptist Health Paducah, Kentucky.
[Ti] Título:Electronic Staff Unit Meetings: A New Model.
[So] Source:J Nurs Adm;48(3):119-122, 2018 Mar.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article discusses how a group of directors and nursing staff in a rural hospital created an innovative unit meeting model using electronic technology to communicate with staff in a more meaningful manner and still comply with regulatory requirements and 2-way information needs.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Recursos Humanos de Enfermagem no Hospital/organização & administração
Videoconferência/organização & administração
[Mh] Termos MeSH secundário: Processos Grupais
Hospitais Rurais/organização & administração
Seres Humanos
Satisfação no Emprego
Recursos Humanos de Enfermagem no Hospital/psicologia
Videoconferência/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000585


  4 / 4373 MEDLINE  
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[PMID]:29385173
[Au] Autor:Fleet R; Bussières S; Tounkara FK; Turcotte S; Légaré F; Plant J; Poitras J; Archambault PM; Dupuis G
[Ad] Endereço:Department of Family Medicine and Emergency Medicine, Université Laval, Québec, QC, Canada.
[Ti] Título:Rural versus urban academic hospital mortality following stroke in Canada.
[So] Source:PLoS One;13(1):e0191151, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Stroke is one of the leading causes of death in Canada. While stroke care has improved dramatically over the last decade, outcomes following stroke among patients treated in rural hospitals have not yet been reported in Canada. OBJECTIVES: To describe variation in 30-day post-stroke in-hospital mortality rates between rural and urban academic hospitals in Canada. We also examined 24/7 in-hospital access to CT scanners and selected services in rural hospitals. MATERIALS AND METHODS: We included Canadian Institute for Health Information (CIHI) data on adjusted 30-day in-hospital mortality following stroke from 2007 to 2011 for all acute care hospitals in Canada excluding Quebec and the Territories. We categorized rural hospitals as those located in rural small towns providing 24/7 emergency physician coverage with inpatient beds. Urban hospitals were academic centres designated as Level 1 or 2 trauma centres. We computed descriptive data on local access to a CT scanner and other services and compared mean 30-day adjusted post-stroke mortality rates for rural and urban hospitals to the overall Canadian rate. RESULTS: A total of 286 rural hospitals (3.4 million emergency department (ED) visits/year) and 24 urban hospitals (1.5 million ED visits/year) met inclusion criteria. From 2007 to 2011, 30-day in-hospital mortality rates following stroke were significantly higher in rural than in urban hospitals and higher than the Canadian average for every year except 2008 (rural average range = 18.26 to 21.04 and urban average range = 14.11 to 16.78). Only 11% of rural hospitals had a CT-scanner, 1% had MRI, 21% had in-hospital ICU, 94% had laboratory and 92% had basic x-ray facilities. CONCLUSION: Rural hospitals in Canada had higher 30-day in-hospital mortality rates following stroke than urban academic hospitals and the Canadian average. Rural hospitals also have very limited local access to CT scanners and ICUs. These rural/urban discrepancies are cause for concern in the context of Canada's universal health care system.
[Mh] Termos MeSH primário: Mortalidade Hospitalar
Hospitais Rurais/estatística & dados numéricos
Hospitais Urbanos/estatística & dados numéricos
Acidente Vascular Cerebral/mortalidade
[Mh] Termos MeSH secundário: Canadá/epidemiologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191151


  5 / 4373 MEDLINE  
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[PMID]:29385378
[Au] Autor:Iglehart JK
[Ad] Endereço:Mr. Iglehart is a national correspondent for the Journal.
[Ti] Título:The Challenging Quest to Improve Rural Health Care.
[So] Source:N Engl J Med;378(5):473-479, 2018 Feb 01.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Disparidades nos Níveis de Saúde
Serviços de Saúde Rural
Saúde da População Rural
[Mh] Termos MeSH secundário: Política de Saúde
Acesso aos Serviços de Saúde
Hospitais Rurais
Seres Humanos
Cobertura do Seguro
Expectativa de Vida
Medicaid
Patient Protection and Affordable Care Act
Atenção Primária à Saúde/recursos humanos
Serviços de Saúde Rural/economia
Serviços de Saúde Rural/recursos humanos
Serviços de Saúde Rural/normas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMhpr1707176


  6 / 4373 MEDLINE  
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[PMID]:29280845
[Au] Autor:Durham-Pressley C; Speroni KG; Kingan MJ; MacDougall EP; Williams M
[Ad] Endereço:Christine Durham-Pressley is a clinical nurse at Shore Behavioral Health at the University of Maryland Shore Medical Center at Dorchester in Cambridge, Md. At the University of Maryland Shore Regional Health in Easton, Md., Karen Gabel Speroni is chair of the nursing research council, Eileen P. MacDougall is the former regional director of accreditation and patient safety, and Michele Williams is a pain and palliative care specialist. Michael J. Kingan is the former director of Shore Wellness Partners in Chestertown and Easton, Md.
[Ti] Título:Nurse perceptions of the family violence screening process and education program in a rural healthcare system.
[So] Source:Nursing;48(1):56-63, 2018 Jan.
[Is] ISSN:1538-8689
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Violência Doméstica
Programas de Rastreamento/enfermagem
Recursos Humanos de Enfermagem no Hospital/psicologia
Educação de Pacientes como Assunto
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Hospitais Rurais
Seres Humanos
Masculino
Mid-Atlantic Region
Meia-Idade
Avaliação de Programas e Projetos de Saúde
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/01.NURSE.0000527617.52655.2f


  7 / 4373 MEDLINE  
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[PMID]:28464825
[Au] Autor:Madrid L; Sitoe A; Varo R; Nhampossa T; Lanaspa M; Nhama A; Acácio S; Riaño I; Casellas A; Bassat Q
[Ad] Endereço:Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
[Ti] Título:Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique.
[So] Source:Malar J;16(1):184, 2017 05 02.
[Is] ISSN:1475-2875
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hypoglycaemia is a frequent complication among admitted children, particularly in malaria-endemic areas. This study aimed to estimate the occurrence of hypoglycaemia not only upon admission but throughout the first 72 h of hospitalization in children admitted with malaria. METHODS: A simple pilot study to continuously monitor glycaemia in children aged 0-10 years, admitted with malaria in a rural hospital was conducted in Southern Mozambique by inserting continuous glucose monitors (CGMs) in subcutaneous tissue of the abdominal area, producing glycaemia readings every 5 min. RESULTS: Glucose was continuously monitored during a mean of 48 h, in 74 children. Continuous measurements of blood glucose were available for 72/74 children (97.3%). Sixty-five of them were admitted with density-specific malaria diagnosis criteria (17 severe, 48 uncomplicated). Five children (7.7%) had hypoglycaemia (<54 mg/dL) on admission as detected by routine capillary determination. Analysing the data collected by the CGMs, hypoglycaemia episodes (<54 mg/dL) were detected in 10/65 (15.4%) of the children, of which 7 (10.8%) could be classified as severe (≤45 mg/dL). No risk factors were independently associated with the presence of at least one episode of hypoglycaemia (<54 mg/dL) during hospitalization. Only one death occurred among a normoglycaemic child. All episodes of hypoglycaemia detected by CGMs were subclinical episodes or not perceived by caregivers or clinical staff. CONCLUSIONS: Hypoglycaemia beyond admission in children with malaria appears to be much more frequent than what had been previously described. The clinical relevance of these episodes of hypoglycaemia in the medium or long term remains to be determined.
[Mh] Termos MeSH primário: Glicemia/análise
Hospitais Rurais/estatística & dados numéricos
Hipoglicemia/epidemiologia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Seres Humanos
Hipoglicemia/etiologia
Lactente
Malária/complicações
Masculino
Moçambique/epidemiologia
Projetos Piloto
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Blood Glucose)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12936-017-1840-x


  8 / 4373 MEDLINE  
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[PMID]:29266903
[Au] Autor:Sparke VL; MacLaren D; Mills J; Asugeni R; Moutoa K; West C
[Ti] Título:IMPROVING INFECTION PREVENTION AND CONTROL PRACTICES IN A CULTURALLY, LINGUISTICALLY AND SPIRITUALLY DIVERSE ENVIRONMENT.
[So] Source:Aust Nurs Midwifery J;24(8):42, 2017 03.
[Is] ISSN:2202-7114
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Atoifi Adventist Hospital (AAH) in the Solomon Islands serves a population of 80,000 people, many living in small remote villages. Atoifi is situated on the east side of the island of Malaita in the East Kwaio region. Kwaio is one of 12 language groups on Malaita and most people engage in the subsistence economy.
[Mh] Termos MeSH primário: Controle de Infecções/organização & administração
[Mh] Termos MeSH secundário: Pesquisa Participativa Baseada na Comunidade/métodos
Diversidade Cultural
Hospitais Rurais
Seres Humanos
Melanesia
Desenvolvimento de Programas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


  9 / 4373 MEDLINE  
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[PMID]:29205017
[Au] Autor:Kauppila JH; Raatiniemi L; Isokangas JM; Martikainen M; Piironen K
[Ti] Título:Drip-and-ship stroke thrombolysis in the emergency department of a healthcare center - a possibility for those fallen ill in rural settings.
[So] Source:Duodecim;133(2):167-71, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Thrombolysis with tissue plasminogen activator is the mainstay in the treatment of acute stroke. Reducing the delay of thrombolysis treatment improves patient prognosis and reduces the incidence of complications. Variable telestroke regimens have improved the availability of stroke thrombolysis, especially in rural settings, where neurologists are not readily available. In the drip-and-ship strategy, stroke thrombolysis is initiated in a peripheral hospital and the patient is then transferred to a tertiary care unit. We report the first case of drip-and-ship stroke thrombolysis in a rural health care center in Northeastern Finland.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência
Fibrinolíticos/uso terapêutico
Hospitais Rurais
Transferência de Pacientes
Acidente Vascular Cerebral/tratamento farmacológico
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Finlândia
Seres Humanos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  10 / 4373 MEDLINE  
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[PMID]:29065073
[Au] Autor:Sosebee T; Potter R; Gilbert V; Newcomb P; Hampton M
[Ad] Endereço:Author Affiliations: Assistant Chief Nursing Officer (Ms Sosebee) All Nursing Services, Texas Health Azle Hospital; Director (Mr Potter), Nursing Emergency Services; and Chief Nursing Officer (Ms Gilbert), all Nursing Services, Texas Health Methodist Hospital Azle; Nurse Scientist (Dr Newcomb), Nursing Operations, Texas Health Resources, Arlington; and Director (Dr Hampton), Nursing Operations, Texas Health Methodist Hospital, Fort Worth.
[Ti] Título:Exploring Acuity-Adaptable Care in a Rural Hospital.
[So] Source:J Nurs Adm;47(11):565-570, 2017 Nov.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The objective of this study is to assess benefits of the acuity-adaptable (AA) care model in rural hospitals. BACKGROUND: The AA model aims to provide care in the same space from admission to discharge regardless of acuity. Evidence is lacking to support claims that AA care will improve patient safety, increase nurse productivity, and improve patient/staff satisfaction in rural hospitals. METHODS: Patients admitted to a rural intensive care unit (ICU) were allocated to an AA group or an ICU group. Patients in the AA group remained in the ICU room through discharge. Patients in the ICU group transferred out of ICU when acuity permitted. Patient anxiety, depression, and perception of emotional care were measured. Staff responses were assessed qualitatively. RESULTS: Acuity-adaptable patients reported significantly more anxiety and less perceived emotional care than ICU patients. Intensive care unit nurses resisted caring for less acute patients. CONCLUSION: Disadvantages may outweigh benefits of AA care delivery in the rural ICU.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Hospitais Rurais/organização & administração
Unidades de Terapia Intensiva/organização & administração
Recursos Humanos de Enfermagem no Hospital/organização & administração
Segurança do Paciente
Satisfação do Paciente
[Mh] Termos MeSH secundário: Adulto
Eficiência Organizacional
Feminino
Grupos Focais
Seres Humanos
Unidades de Terapia Intensiva/normas
Tempo de Internação
Masculino
Meia-Idade
Modelos Organizacionais
Relações Enfermeiro-Paciente
Recursos Humanos de Enfermagem no Hospital/psicologia
Transferência da Responsabilidade pelo Paciente/normas
Transferência da Responsabilidade pelo Paciente/estatística & dados numéricos
Transferência de Pacientes/normas
Transferência de Pacientes/estatística & dados numéricos
Projetos Piloto
Avaliação de Programas e Projetos de Saúde
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000544



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