Rural Remote Health
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Rural Remote Health · Jan 2014
Successful mobile phone network-based approach to integration of the health care system in rural Laos: strengthening lay health worker performance.
Little has been reported regarding how the effects of mobile phone-based improvements to healthcare worker communications may improve the activities of lay health workers, who form the crucial bridge between the official healthcare system and rural/remote communities. The objective of this study was to establish and assess the usefulness of a mobile phone-based communication network between village health volunteers (VHVs) and their supervisors in a rural district of Laos. ⋯ The district-wide mobile phone communication network facilitated regular reporting, the seeking of advice, and the delivery of information regarding scheduling of various activities. The improved frequency and quality of communications has strong potential to translate into an improvement in health outcomes of people living in geographically remote and rural communities.
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Rural Remote Health · Jan 2014
Building capacity in the rural physiotherapy workforce: a paediatric training partnership.
Building capacity in the rural physiotherapy workforce: a paediatric training partnership' provided 6 months postgraduate paediatric clinical and academic training for two physiotherapists in rural Australia. It is described as a model for improving services and workforce retention. The need for 'an appropriate, skilled and well-supported health workforce' is the third goal in Australia's National Strategic Framework for Rural and Remote Health 2011. The World Health Organization recently published its first global policy for improving the retention of rural and remote health workers. Education is its first recommendation and aims to 'design continuing education and professional development programmes that meet the needs of rural health workers and that are accessible from where they live and work, so as to support their retention …'. Additionally, '… to be successful, continuing education needs to be linked to career paths, as well as with other education interventions'. ⋯ The paediatric physiotherapy training program was enabled through initial funding for a 12-month pilot project. Further government funding built on that success for this reported 6-month project. Funding to employ the postgraduate physiotherapists was essential to the success of the clinical training program, and lack of future funding is a barrier to its sustainability. The program included the consolidation of the initial management and education committees and the expert reference group. Weekly tutorials, case studies and presentations formed an important part of clinical rotation between hospital outpatients, specialist school and the disability sector. This increased the provision of skilled paediatric physiotherapy services close to home in a timely fashion not previously available. Concurrently, the training increased the clinicians' paediatric knowledge and confidence, promoting workforce retention by providing a career pathway. The senior clinicians who provided clinical supervision reported that it enabled succession planning through introduction of appropriately skilled younger peers to their clinical practice. Project recommendations are that funding and stakeholder partnerships are necessary to enable health professionals to undertake postgraduate clinical training in paediatrics in rural areas. The partnership should include education providers (university), rural health service providers (hospital) and community or disability services (government and non-government) with financial recognition of expertise in the rural workforce for clinical supervision. The training experience was reported as a very positive experience from trainees, families, clinical supervisors, managers, academics and paediatricians. Lack of continued funding to educate skilled postgraduate paediatric physiotherapy clinicians means that rural children with physical disabilities will continue to be disadvantaged.
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Rural Remote Health · Jan 2014
Extreme nursing: a qualitative assessment of nurse retention in a remote setting.
Nurses have practiced in Bristol Bay, Alaska, since 1896. Practice opportunities are defined by institutional structures and systems; and the geography, climate, and history of remote South-west 'bush' Alaska. The Native Alaskan culture as experienced through nurses' practice, community relations, and in several cases, marriages, shapes their lives as well. The purposes of this qualitative study are three-fold: (1) to ensure the unique stories of bush Alaska nurses are preserved and told; (2) to foster a strong bush nursing tradition; and (3) to inform recruitment, hiring, and retention practices in remote settings. ⋯ Long-term retained bush nurses share three characteristics useful to successful recruitment and retention efforts: they have (1) a strong sense of adventure, (2) an independent outlook regarding family growth and development, and (3) a deep appreciation of Native Alaskan culture and lifestyle. In summary they advise nurses who wish to practice and stay in the bush to come with 'ample resources, mental resources, emotional, spiritual, the whole nine yards, [they] need these resources in order to survive, in order to stay here. [Also] a love for the people, not being opposite to the culture but trying to learn [from it]'. Attributes and qualities nurses bring to remote South-west bush Alaska produce a community dynamic affecting practice, health, and quality of life.
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Rural Remote Health · Jan 2014
Degree of value alignment - a grounded theory of rural nurse resignations.
The shortage of nurses willing to work in rural Australian healthcare settings continues to worsen. Australian rural areas have a lower retention rate of nurses than metropolitan counterparts, with more remote communities experiencing an even higher turnover of nursing staff. When retention rates are lower, patient outcomes are known to be poorer. This article reports a study that sought to explore the reasons why registered nurses resign from rural hospitals in the state of New South Wales, Australia. ⋯ To fully comprehend rural nurse resignations, this study identified three stages that nurses move through prior to resignation. Effective retention strategies for the nursing workforce should address contributors to a decrease in value alignment and work towards encouraging the coalescence of nurses' and hospitals' values. It is imperative that strategies enable nurses to provide high quality patient care and promote a sense of connectedness and a shared vision between nurse and hospital. Senior managers need to have clear ways to articulate and imbue organisational values and be explicit in how these values accommodate nurses' values. Ward-level nurse managers have a significant responsibility to ensure that a hospital's values (both explicit and implicit) are incorporated into ward culture.
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Rural Remote Health · Jan 2014
Twenty cultural and learning principles to guide the development of pharmacy curriculum in Pacific Island countries.
A lack of education capacity to support the development of medical supply management competency is a major issue affecting Pacific Islands countries (PICs). Limited human resources and underdeveloped medicines supply management competency are two significant impediments to reaching the health-related Millennium Development Goals in many countries in this rural and remote region. Two recent review publications have provided relevant background documenting factors affecting learning and teaching. These articles have presented available information regarding competency and training requirements for health personnel involved in essential medicine supply management in the region. This background research has provided a platform from which tangible principles can be developed to aid educators and professionals in PICs in the development and delivery of appropriate pharmacy curriculum. Specifically the aim of the present article is to identify culturally meaningful learning and teaching principles to guide the development and delivery of pharmaceutical curriculum in PICs. Subsequently, this information will be applied to develop and trial new pedagogical approaches to the training of health personnel involved in essential medicines supply management, to improve medicine availability for patients in their own environment. This article forms part of a wider research project involving the United Nations Population Fund Suva subregional office, the University of Canberra, Ministry of Health officials and health personnel within identified PICs. ⋯ The 20 principles outlined in this article will be used to develop and trial culturally relevant training approaches for the development of medicine management competencies for various cadres of health personnel in PICs. These principles provide a practical framework for educators and health professionals to apply to health-based education and training in the Pacific, with potential application to other rural and remote environments.