Seright Teresa J, Winters Charlene A
Teresa J. Seright is Associate Dean for UG Programs in the College of Nursing, Montana State University. She has maintained critical care certification (CCRN) through direct patient care in the emergency/trauma center and catheterization laboratory at Trinity Health, Minot, North Dakota, and the emergency department and recovery room at Bozeman Deaconess Hospital, Bozeman, Montana.Charlene A. Winters is a professor in the College of Nursing, Montana State University, focusing on issues related to rural health and rural health care practice.
Crit Care Nurse. 2015 Oct;35(5):62-7. doi: 10.4037/ccn2015115.
What began as a grant-funded demonstration project, as a means of bridging the gap in rural health care, has developed into a critical access hospital system comprising 1328 facilities across 45 states. A critical access hospital is not just a safety net for health care in a rural community. Such hospitals may also provide specialized services such as same-day surgery, infusion therapy, and intensive care. For hospitals located near the required minimum of 35 miles from a tertiary care center, management of critically ill patients may be a matter of stabilization and transfer. Critical access hospitals in more rural areas are often much farther from tertiary care; some of these hospitals are situated within frontier areas of the United States. This article describes the development of critical access hospitals, provision of care and services, challenges to critical care in critical access hospitals, and suggestions to address gaps in research and collaborative care.
最初作为一个由拨款资助的示范项目，作为弥合农村医疗保健差距的一种手段，如今已发展成为一个覆盖45个州、拥有1328家医疗机构的临界接入医院系统。临界接入医院不仅仅是农村社区医疗保健的安全网。这类医院还可能提供诸如当日手术、输液治疗和重症监护等专科服务。对于距离三级护理中心至少35英里的医院来说，重症患者的管理可能只是稳定病情并进行转运的问题。农村地区更远的临界接入医院往往距离三级护理中心更远；其中一些医院位于美国的边境地区。本文描述了临界接入医院的发展、护理和服务的提供、临界接入医院重症护理面临的挑战，以及解决研究和协作护理差距的建议。
