OBJECTIVE To explore the reasons why individuals recurrently present with asthma to hospital emergency departments. DESIGN A predominantly qualitative study in which participants were interviewed in-depth about their asthma. Data on medication use, respiratory health and asthma knowledge were also collected, and asthma severity was determined from medical records. SETTING A tertiary teachin...

OBJECTIVE To examine, using nationally representative data, which patient, hospital, and county characteristics influence rural residents' urban hospitalization. METHODS Rural residents hospitalized in urban hospitals (crossovers) are compared with those hospitalized in rural hospitals (noncrossovers). National Hospital Discharge Survey data were merged with Area Resource File and Centers for...

With 2.7 trillion dollars in annual health spending, America has no excuse for designs that have failed for decades with regard to rural health workforce development. Rural workforce failure can best be understood as the inevitable result of failure by design. Designs for revenue are insufficient to support the rural clinician workforce that would resolve deficits. The designs of health profess...

The World Health Organisation estimates there are approximately 3 million cases of needlestick injury (NSI) in healthcare workers (HCW) each year, with 90% of these occurring in developing countries 1 . Student nurses are thought to be at high risk of NSI due to poor technique, inexperience and poor use of universal precautions 2 . There has been little research into the incidence of NSI in Afr...

Faculty in Canadian undergraduate nursing programs have come to rely on preceptorship as the primary model for teaching and learning during the final clinical course. A focused ethnography was completed in order to examine undergraduate nursing students' experience of rural hospital preceptorship in western Canada. Data analysis revealed that students perceive nursing faculty involvement and su...

Sodium reduction strategies on a population-based level are promoted as a public health intervention. Small and rural hospitals in Illinois were funded to adopt sodium reduction strategies as an intervention, have their hospital cafeteria and vending machines assessed via an environmental scan, and participate in an evaluation. Intervention strategies to identify and to label lower-sodium foods...

This article describes the emerging trend of using metrics in rural hospitals to achieve world-class performance. This trend is a response to the fact that rural hospitals have small patient volumes yet must maintain a profit margin in order to fulfill their mission to the community. The conceptual idea for this article is based largely on Robert Kaplan and David Norton's Balanced Scorecard art...

Congress introduced the Rural Health Care Transition (RHCT) Grant Program in 1989 to assist financially troubled, small rural hospitals. This article discusses grant effects on the second cohort of hospitals to complete their 3-year grants. Although three-quarters of the grantees implemented all or most of their goals, 11 percent could not implement a viable project. Grantees added or upgraded ...

Even the smallest, most isolated rural hospitals are now required to have bioterrorism preparedness plans. From the perspective of many rural hospitals, however, there is a disparity between Federal expectations and the realities of small hospitals operating in geographically isolated communities. As part of an effort to better understand how to close this gap, the Walsh Center for Rural Health...

Many rural communities across canada are facing challenges to the sustainability of core emergency and acute care health services, primarily due to problems with medical and nursing staffing. Data related to service efficacy and effectiveness are not well organized. Most of Canada still relies on reporting by large geopolitical areas (local health areas) that do not always relate natural catchm...