ABSTRACT
A review of rural-based critical care nursing has demonstrated that quality critical care can be delivered within the constraints of rural practice. The barriers most often found affecting rural care have been described. Proven realistic strategies to these barriers have been delineated. A distinct advantage of rural nursing is the increased amount of change and influence a single nurse can have on the community health care system. The rural nurse manager has the opportunity to create a critical care nursing service with high levels of accountability, that can quickly respond to change, and that produces quality patient care. By accomplishing these goals, rural critical care nurses will leave a meaningful legacy of enhanced lives and improved health for their rural communities.
Subject(s)
Critical Care , Hospitals, Rural , Nursing Service, Hospital/standards , Rural Population , Clinical Competence , Critical Care/standards , Delivery of Health Care/standards , Health Services Needs and Demand , Hospitals, Rural/organization & administration , Hospitals, Rural/standards , Humans , Intensive Care Units/organization & administration , Intensive Care Units/standards , Models, Nursing , Nurse Administrators/education , Quality of Health Care/standards , Social Isolation , WorkforceABSTRACT
We present minicholecystectomy as a means of cost containment and discharge from the hospital 24 to 48 hours later. Among 450 patients undergoing this form of cholecystectomy through a 4 cm incision, only 49 stayed longer than an average of 1.2 days; all of those patients had preexisting surgical problems, some of which were corrected concurrently. Forty-two patients were admitted on the morning of the day of operation and stayed an average of 1.07 days. The mortality was 1/450 (0.2%); the complication rate was 3.1%. We have found the shorter and earlier procedure an excellent and safe means of cost containment and recommend that earlier discharge be considered for other procedures as well.
