HealthDay News — Obstacles and helpful behavior items unique to critical access hospitals, created to bring health care to rural populations, rank below the top 10 items for nurses, according to a study published online Sept. 1 in the American Journal of Critical Care.

Renea L. Beckstrand, Ph.D., R.N., from the Brigham Young University College of Nursing in Provo, Utah, and colleagues surveyed a sample of nurses working in 39 critical access hospitals. The nurses were asked to score obstacle and helpful behavior items; these items were then ranked from highest to lowest.

The researchers found that seven of the top 10 obstacles were directly related to behaviors and attitudes of family, including lack of understanding about what lifesaving measures entail and internal disagreement relating to life support. Interventions that were controlled by nurses and items that affected the nurses having adequate time to deliver end-of-life care were included as helpful behaviors ranked in the top 10. Lack of resources and the nurse knowing the patient or the patient’s family were obstacles and helpful behavior items that were unique to critical access hospitals and were ranked below the top 10 items.

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“The obstacles faced by critical access hospital nurses are similar to those faced by their urban counterparts,” the authors write. “Nurses in critical access hospitals have different challenges in caring for dying patients because of the lack of equipment and expertise; yet these nurses believe they provide high-quality end-of-life care to their rural patients.”

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