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Remote area nursing

Jane Yelland, Donna Weetra, Deanna Stuart-Butler, Janiene Deverix, Cathy Leane, Jackie Ah Kit, Karen Glover, Deirdre Gartland, Jonathan Newbury, Stephanie Brown
OBJECTIVE: To investigate the extent to which Aboriginal women access primary care for themselves and their infant in the year after childbirth. METHOD: Cross sectional population-based survey of women giving birth to Aboriginal babies in South Australia between July 2011 and June 2013. RESULTS: A total of 344 women took part in the study 4-9 months after giving birth. The majority had seen a primary health care practitioner since the birth: 86% had seen a Child and Family Health Service (CaFHS) nurse, 81% a general practitioner (GP), and 61% an Aboriginal health worker (AHW)...
October 2016: Australian and New Zealand Journal of Public Health
Lareen Newman, Niranjan Bidargaddi, Geoffrey Schrader
BACKGROUND: Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. OBJECTIVE: Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia...
October 2016: International Journal of Medical Informatics
Anita D'Aprano, Sven Silburn, Vanessa Johnston, Ross Bailie, Fiona Mensah, Frank Oberklaid, Gary Robinson
INTRODUCTION: Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services. METHODS: A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011...
July 2016: Rural and Remote Health
Alison Moores, Paula Puawe, Nancy Buasi, Florence West, Mary K Samor, Nina Joseph, Michele Rumsey, Angela Dawson, Caroline S E Homer
BACKGROUND: Papua New Guinea has a very high maternal mortality rate (773/100,000), low rates of supervised births and a critical shortage of skilled midwives. A midwifery education initiative commenced in 2012, funded by the Australian Government and led by the National Department of Health. One specific objective of the initiative was to improve the standard of clinical teaching and practice in four schools of midwifery. There were 394 midwives educated over the 4 year period (2012-2015) representing half of all midwives in Papua New Guinea...
October 2016: Midwifery
Dania Nathanson, Susan Woolfenden, Karen Zwi
In Australia, paediatricians and Child Protection Specialists provide the medical and forensic examinations of child victims of sexual assault. There are workforce challenges in the recruitment and retention of doctors to undertake child sexual assault (CSA) work particularly in remote and rural areas. Pediatric Sexual Assault Nurse Examiner (PSANE) programs have existed in the USA and the UK for many years. Using Rapid Evidence Assessment (REA) methodology, a systematic search of the literature was performed to ascertain what is known about SANE programs, to evaluate the evidence for their effectiveness across a number of domains (accessibility, health and legal outcomes and cost effectiveness) and to inform policy on models of care and elements of best practice which may be appropriate for local implementation in Australia...
September 2016: Child Abuse & Neglect
José Pereira, Jocelyne Contant, Gwen Barton, Christopher Klinger
BACKGROUND: Regionalization promotes planning and coordination of services across settings and providers to meet population needs. Despite the potential advantages of regionalization, no regional hospice palliative care program existed in Ontario, Canada, as of 2010. This paper describes the process and early results of the development of the first regional hospice palliative care program in Ontario. The various activities and processes undertaken and the formal agreements, policies and documents are described...
2016: BMC Palliative Care
Sue Kruske, Sue Kildea, Bec Jenkinson, Jennifer Pilcher, Sarah Robin, Margaret Rolfe, Jude Kornelsen, Lesley Barclay
BACKGROUND: Primary Maternity Units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. DESIGN: a descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia...
September 2016: Midwifery
Metilda Robin, Teenu Xavier, Deepak Agrawal
UNLABELLED: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. AIMS AND OBJECTIVES: The aim of this study was to evaluate the effectiveness of tele-consultation by nurses using an integrated call centre. MATERIALS AND METHODS: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India...
2016: Studies in Health Technology and Informatics
Rosemary McKenzie, Michelle Williamson, Rebecca Roberts
BACKGROUND: The 'after hours GP helpline' was added to the existing 24-hour nurse triage and advice lines in Australia in July 2011. Its objective is to improve access to GP advice in the after-hours period. OBJECTIVE: The objective of this study was to describe the user profile of an after-hours primary care helpline during its first two years of operation, including age, gender, location and relative socioeconomic advantage of users. METHODS: The study undertook a retrospective review and descriptive analysis of the use and user characteristics during a two-year period in 2011-13...
May 2016: Australian Family Physician
Lipika Samal, Patricia C Dykes, Jeffrey O Greenberg, Omar Hasan, Arjun K Venkatesh, Lynn A Volk, David W Bates
BACKGROUND: Health information technology (HIT) could improve care coordination by providing clinicians remote access to information, improving legibility, and allowing asynchronous communication, among other mechanisms. We sought to determine, from a clinician perspective, how care is coordinated and to what extent HIT is involved when transitioning patients between emergency departments, acute care hospitals, skilled nursing facilities, and home health agencies in settings across the United States...
2016: BMC Health Services Research
Katy B Kozhimannil, Carrie Henning-Smith, Peiyin Hung
INTRODUCTION: Workforce shortages limit access to care for pregnant women in rural and remote areas. The goal of this analysis was to describe the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variation in rural CNM practice. METHODS: We identified 306 rural hospitals with at least 10 births in 2010 using discharge data from the Statewide Inpatient Databases for 9 US states. We conducted a telephone survey of hospital maternity unit managers (N = 244) from November 2013 to March 2014 to understand their maternity care workforce and practice models...
July 2016: Journal of Midwifery & Women's Health
Sylvain Bussières, Alain Tanguay, Denise Hébert, Richard Fleet
Access to health care in Canada's rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d'Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care...
April 11, 2016: Journal of Telemedicine and Telecare
Angelo S Nyamtema, Nguke Mwakatundu, Sunday Dominico, Hamed Mohamed, Senga Pemba, Richard Rumanyika, Clementina Kairuki, Irene Kassiga, Allan Shayo, Omary Issa, Calist Nzabuhakwa, Chagi Lyimo, Jos van Roosmalen
BACKGROUND: In Tanzania, maternal mortality ratio (MMR), unmet need for emergency obstetric care and health inequities across the country are in a critical state, particularly in rural areas. This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC) services in underserved rural areas using associate clinicians. METHODS: Ten health centres (HCs) were upgraded by constructing and equipping maternity blocks, operating rooms, laboratories, staff houses and installing solar panels, standby generators and water supply systems...
2016: PloS One
Megan Ireland, Luciana Cavalini, Sabado Girardi, Edson C Araujo, Magnus Lindelow
BACKGROUND: Brazil has experienced difficulties in attracting health professionals (especially doctors and nurses) to practice at the primary health care (PHC) level and in rural and remote areas. This study presents two case studies, each a current initiative in contracting for primary health services in Brazil: one for the state of Bahia and the other for the city of Rio de Janeiro. The two models differ considerably in context, needs, modalities, and outcomes. This article does not attempt to evaluate the initiatives but to identify their strengths and weaknesses...
2016: Human Resources for Health
Kathryn L Andersen, Indira Basnett, Dirgha Raj Shrestha, Meena Kumari Shrestha, Mukta Shah, Shilu Aryal
INTRODUCTION: The termination of unwanted pregnancies up to 12 weeks' gestation became legal in Nepal in 2002. Many interventions have taken place to expand access to comprehensive abortion care services. However, comprehensive abortion care services remain out of reach for women in rural and remote areas. This article describes a training and support strategy to train auxiliary nurse-midwives (ANMs), already certified as skilled birth attendants, as medical abortion providers and expand geographic access to safe abortion care to the community level in Nepal...
March 2016: Journal of Midwifery & Women's Health
Susan Bragg, Ann Bonner
BACKGROUND: Australian workforce planning predicts a shortfall of nurses by 2025 with rural areas being most at risk. Rural areas have lower retention rates of nurses than metropolitan areas, with remote communities experiencing an even higher turnover of nursing staff. There have been few studies that examine the impact of nurse resignations on rural nursing workforces. OBJECTIVE: This paper is abstracted from a larger study into the reasons why nurses resign from rural hospitals and explores the resignation period...
December 2015: Australian Journal of Rural Health
Desley Hegney, Robert Eley, Rebecca Osseiran-Moisson, Karen Francis
OBJECTIVE: This study aims to ascertain if differences exist in the perception of the professional practice environment and personal well-being of nurses across different geographical areas in Queensland. DESIGN: This paper was performed on a prospective, self-report cross-sectional on-line survey. SETTING: The study was conducted among the nurses employed in public and private health care settings: acute hospitals, community health and aged care in Queensland, Australia...
December 2015: Australian Journal of Rural Health
Ashkan M Abbey, Cagri G Besirli, David C Musch, Chris A Andrews, Antonio Capone, Kimberly A Drenser, David K Wallace, Susan Ostmo, Michael Chiang, Paul P Lee, Michael T Trese
PURPOSE: To determine if (1) tortuosity assessment by a computer program (ROPtool, developed at the University of North Carolina, Chapel Hill, and Duke University, and licensed by FocusROP) that traces retinal blood vessels and (2) assessment by a lay reader are comparable with assessment by a panel of 3 retinopathy of prematurity (ROP) experts for remote clinical grading of vascular abnormalities such as plus disease. DESIGN: Validity and reliability analysis of diagnostic tools...
February 2016: Ophthalmology
Jane Davis, Kim Zuber
Whether it is the heartland of America or a remote village in a developing country, one overriding theme to providing care for kidney patients is person power--or the lack of it. In the developed countries, notably the U.S., Australia, New Zealand and Europe, medical schools prepare advanced practitioners who can then fill the gap left by the lack of nephrologists. However in areas where physicians are in short supply, nurses often have only basic training and trained APs are not available. In the meantime, kidney disease is taking its toll on the best and the brightest...
November 2015: Nephrology News & Issues
Milovan Matovic, Marija Jeremic, Vlade Urosevic, Miroslav Ravlic, Marina Vlajkovic
OBJECTIVE: Following radionuclide therapy, patients usually must remain hospitalised in special "restricted access area" 2-5 days, until radiation in their body drops below a certain level. During this period medical personnel can be faced with some challenges. Based on our previous experience, we used telemedicine approach as solution for it. We have developed comprehensive telemedicine system, which consists of three own developed hardware & software modules which are accessible remotely...
September 2015: Hellenic Journal of Nuclear Medicine
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