Results from a World Health Organization pilot of the Basic Emergency Care Course in Sub Saharan Africa
Autoři:
Andrea G. Tenner aff001; Hendry R. Sawe aff002; Stas Amato aff003; Joseph Kalanzi aff004; Muhumpu Kafwamfwa aff005; Heike Geduld aff006; Nikki Roddie aff007; Teri A. Reynolds aff007
Působiště autorů:
Emergency Department, University of California San Francisco, San Francisco, California, United States of America
aff001; Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
aff002; Department of General Surgery, University of Vermont, Newport, Vermont, United States of America
aff003; Department of Emergency Medicine, Makerere University, Kampala, Uganda
aff004; Cavendish University Zambia, Lusaka, Zambia
aff005; Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
aff006; Department for the Management of NCDs, Disability, Violence and Injury Prevention, World Health Organization (WHO), Geneva, Switzerland
aff007
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0224257
Souhrn
Background
Frontline providers around the world deliver emergency care daily, often without prior dedicated training. In response to multiple country requests for open-access, basic emergency care training materials, the World Health Organization (WHO), in collaboration with the International Committee of the Red Cross (ICRC) and the International Federation for Emergency Medicine (IFEM), undertook development of a course for health care providers—Basic Emergency Care: Approach to the acutely ill and injured (BEC). As part of course development, pilots were performed in Uganda, the United Republic of Tanzania, and Zambia to evaluate course feasibility and appropriateness. Here we describe participant and facilitator feedback and pre- and post-course exam performance.
Methods
A mixed methods research design incorporated pre- and post-course surveys as well as participant examination results to assess the feasibility and utility of the course, and knowledge transfer. Quantitative data were analyzed using Stata, and simple descriptive statistics were used to describe participant demographics. Survey data were coded and grouped by themes and analyzed using ATLAS.ti.
Results
Post-course test scores showed significant improvement (p-value < 0.05) as compared to pre-course. Pre- and post-course questionnaires demonstrated significantly increased confidence in managing emergency conditions. Participant-reported course strengths included course appropriateness, structure, language level and delivery methods. Suggested changes included expanding the 4-day duration of the course.
Conclusion
This pilot demonstrates that a low-fidelity, open-access course taught by local instructors can be successful in knowledge transfer. The BEC course was well-received and deemed context-relevant by pilot facilitators and participants in three East African countries. Further studies are needed to evaluate this course’s impact on clinical practice and patient outcomes.
Klíčová slova:
Death rates – Critical care and emergency medicine – Medical doctors – Nurses – Language – Syntax – Global health – Zambia
Zdroje
1. Razzak JA, Kellermann AL. Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ. 2002;80(11):900–5. 12481213
2. Gove S, Tamburlini G, Molyneux E, Whitesell P, Campbell H. Development and technical basis of simplified guidelines for emergency triage assessment and treatment in developing countries. WHO Integrated Management of Childhood Illness (IMCI) Referral Care Project. Arch Dis Child. 1999 Dec;81(6):473–7. doi: 10.1136/adc.81.6.473 10569960
3. Reyes H, Tomé P, Guiscafré H, Martínez H, Romero G, Portillo E, et al. [The verbal autopsy on children with a respiratory infection and acute diarrhea. An analysis of the disease-care-death process]. Boletín Médico Hosp Infant México. 1993 Jan;50(1):7–16.
4. Nolan T, Angos P, Cunha AJ, Muhe L, Qazi S, Simoes EA, et al. Quality of hospital care for seriously ill children in less-developed countries. Lancet Lond Engl. 2001 Jan 13;357(9250):106–10.
5. Meaney PA, Sutton RM, Tsima B, Steenhoff AP, Shilkofski N, Boulet JR, et al. Training hospital providers in basic CPR skills in Botswana: Acquisition, retention and impact of novel training techniques. Resuscitation. 2012 Dec;83(12):1484–90. doi: 10.1016/j.resuscitation.2012.04.014 22561463
6. Arreola-Risa C, Vargas J, Contreras I, Mock C. Effect of emergency medical technician certification for all prehospital personnel in a Latin American city. J Trauma. 2007 Oct;63(4):914–9. doi: 10.1097/TA.0b013e31806bf141 18090026
7. Husum H, Gilbert M, Wisborg T. Training pre-hospital trauma care in low-income countries: the “Village University” experience. Med Teach. 2003 Jan 1;25(2):142–8. doi: 10.1080/0142159031000092526 12745521
8. Zaeem-ul-Haq null, Qureshi F, Hafeez A, Zafar S, Mohamud BK, Southal DP. Evidence for improvement in the quality of care given during emergencies in pregnancy, infancy and childhood following training in life-saving skills: a postal survey. JPMA J Pak Med Assoc. 2009 Jan;59(1):22–6. 19213372
9. Mock CN, Tiska M, Adu-Ampofo M, Boakye G. Improvements in prehospital trauma care in an African country with no formal emergency medical services. J Trauma. 2002 Jul;53(1):90–7. doi: 10.1097/00005373-200207000-00018 12131396
10. O’Hare BA, Nakakeeto M, Southall DP. A pilot study to determine if nurses trained in basic neonatal resuscitation would impact the outcome of neonates delivered in Kampala, Uganda. J Trop Pediatr. 2006 Oct;52(5):376–9. doi: 10.1093/tropej/fml027 16782724
11. Dempsey E, Pammi M, Ryan AC, Barrington KJ. Standardised formal resuscitation training programmes for reducing mortality and morbidity in newborn infants. Cochrane Database Syst Rev. 2015;9:CD009106.
12. Husum H, Gilbert M, Wisborg T, Van Heng Y, Murad M. Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma. 2003 Jun;54(6):1188–96. doi: 10.1097/01.TA.0000073609.12530.19 12813342
13. Ali J, Adam R, Butler AK, Chang H, Howard M, Gonsalves D, et al. Trauma outcome improves following the advanced trauma life support program in a developing country. J Trauma. 1993 Jun;34(6):890–8; discussion 898–899. doi: 10.1097/00005373-199306000-00022 8315686
14. Joshipura MK, Shah HS, Patel PR, Divatia PA, Desai PM. Trauma care systems in India. Injury. 2003 Sep;34(9):686–92. doi: 10.1016/s0020-1383(03)00163-3 12951294
15. Jayaraman S, Sethi D. Advanced trauma life support training for hospital staff. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD004173. doi: 10.1002/14651858.CD004173.pub3 19370594
16. Spiwak R, Lett R, Rwanyuma L, Logsetty S. Creation of a standardized burn course for Low Income Countries: Meeting local needs. Burns. 2014 Nov 1;40(7):1292–9. doi: 10.1016/j.burns.2014.01.007 24685348
17. Brennan MM, Fitzpatrick JJ, McNulty SR, Campo T, Welbeck J, Barnes G. Paediatric resuscitation for nurses working in Ghana: an educational intervention. Int Nurs Rev. 2013 Mar 1;60(1):136–43. doi: 10.1111/j.1466-7657.2012.01033.x 23406249
18. Kadish HA, Bolte RG, Santora SD, Espinoza R, Woodward GA. Evaluating the effectiveness of a pediatric trauma educational program in Central America. Pediatr Emerg Care. 1996 Dec;12(6):407–10. doi: 10.1097/00006565-199612000-00005 8989786
19. Urbano J, Matamoros MM, López-Herce J, Carrillo AP, Ordóñez F, Moral R, et al. A paediatric cardiopulmonary resuscitation training project in Honduras. Resuscitation. 2010 Apr;81(4):472–6. doi: 10.1016/j.resuscitation.2010.01.007 20149517
20. Mirkuzie AH, Sisay MM, Bedane MM. Standard basic emergency obstetric and neonatal care training in Addis Ababa; trainees reaction and knowledge acquisition. BMC Med Educ. 2014 Sep 24;14:201. doi: 10.1186/1472-6920-14-201 25248410
21. Black RS, Brocklehurst P. A systematic review of training in acute obstetric emergencies. BJOG Int J Obstet Gynaecol. 2003 Sep;110(9):837–41.
22. Dresang LT, González MMA, Beasley J, Bustillo MC, Damos J, Deutchman M, et al. The impact of Advanced Life Support in Obstetrics (ALSO) training in low-resource countries. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2015 Nov;131(2):209–15.
23. Kobusingye OC, Hyder AA, Bishai D, Hicks ER, Mock C, Joshipura M. Emergency medical systems in low- and middle-income countries: recommendations for action. Bull World Health Organ. 2005 Aug;83(8):626–31. 16184282
24. American Heart Association | To be a relentless force for a world of longer, healthier lives. [Internet]. www.heart.org. [cited 2018 Sep 19]. Available from: https://www.heart.org/en
25. WORLD HEALTH ORGANIZATION. BASIC EMERGENCY CARE: approach to the acutely ill and injured. S.l.: WORLD HEALTH ORGANIZATION; 2018.
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2019 Číslo 11
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