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首页> 外文期刊>MCN: American Journal of Maternal-Child Nursing >Challenges faced in providing safe care in rural perinatal settings.
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Challenges faced in providing safe care in rural perinatal settings.

机译：在农村围产期环境中提供安全护理面临的挑战。

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PURPOSE: To examine and describe neonatal resuscitation preparedness, presence of connections to wider systems of care, continuing education activities, presence of trained staff, and other indicators of high performance in rural perinatal microsystems. STUDY DESIGN AND METHODS: A nonexperimental, retrospective, descriptive, cross-sectional design was utilized. Rural hospitals (n = 124) providing perinatal services in five southern states were invited to participate. Nurse managers completed the Hospital Neonatal Resuscitation Survey, describing policies, healthcare team members, educational activities, organizational culture, system connections, and process improvement. Descriptive data were also collected. RESULTS: A total of 44 (35.1%) hospitals participated. Annual birth volume ranged from 22 to 1,614 (M = 515.53; SD = 336.27). Low birth volume hospitals (<125 births per year) had significantly lower levels of preparedness than high volume hospitals (>125 births per year). Preparedness was not influenced by rurality. One-third (34.1%) did not identify relationships with Level III NICUs. Support of continuing education was universal. Efforts to increase interdisciplinary teamwork were common. Medical provider shortages were prevalent (n = 25: 56.8%), and the presence of midwifery services was infrequent (n = 12; 27.2%). Hospital nursing shortages (n = 35; 81.8%) were widespread. CLINICAL IMPLICATIONS: Challenges faced by rural hospitals and healthcare professionals in the delivery of perinatal care emphasize the importance of creating and maintaining high performance microsystems that are responsive to the changing needs of providers and the populations they serve. Lower levels of preparedness and the lack of established relationships with level III NICUs is concerning.
机译：目的：检查和描述新生儿复苏的准备情况，与更广泛的护理系统的联系，继续教育活动，训练有素的工作人员的存在以及农村围产期微型系统中其他高性能的指标。研究设计和方法：采用非实验性，回顾性，描述性，横截面设计。邀请了南部五个州的提供围产期服务的乡村医院（n = 124）参加。护士经理完成了医院新生儿复苏调查，描述了政策，医疗团队成员，教育活动，组织文化，系统联系和流程改进。还收集了描述性数据。结果：总共有44家医院（35.1％）参加了活动。年出生量在22至1,614之间（M = 515.53; SD = 336.27）。低出生量医院（每年<125例出生）的备灾水平明显低于高容量医院（每年> 125例出生）。备灾不受乡村影响。三分之一（34.1％）的人没有发现与III级重症监护病房的关系。继续教育的支持是普遍的。加强跨学科团队合作的努力很普遍。医疗服务提供者短缺普遍存在（n = 25：56.8％），并且很少有助产士服务（n = 12; 27.2％）。医院护理短缺现象普遍存在（n = 35; 81.8％）。临床意义：农村医院和医护人员在提供围产期护理时面临的挑战强调了创建和维护高性能微系统的重要性，这些微系统可以响应提供者及其服务人群不断变化的需求。较低的准备水平以及与III级重症监护病房之间缺乏既定关系令人担忧。

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