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https://open.uns.ac.rs/handle/123456789/6988
Title: | A survey on critical care resources and practices in low- and middle-income countries | Authors: | Marija Vukoja Riviello E. Gavrilović, Srđan Adhikari N. Kashyap R. Bhagwanjee S. Gajić, Ognjen Kilickaya O. |
Keywords: | critical care;intensive care units;checklists | Issue Date: | 1-Jan-2014 | Journal: | Global Heart | Abstract: | © 2014 World Heart Federation (Geneva). Background: Timely and appropriate care is the key to achieving good outcomes in acutely ill patients, but the effectiveness of critical care may be limited in resource-limited settings. Objectives: This study sought to understand how to implement best practices in intensive care units (ICU) in low- and middle-income countries (LMIC) and to develop a point-of-care training and decision-support tool. Methods: An internationally representative group of clinicians performed a 22-item capacity-and-needs assessment survey in a convenience sample of 13 ICU in Eastern Europe (4), Asia (4), Latin America (3), and Africa (2), between April and July 2012. Two ICU were from low-income, 2 from low-middle-income, and 9 from upper-middle-income countries. Clinician respondents were asked about bed capacity, patient characteristics, human resources, available medications and equipment, access to education, and processes of care. Results: Thirteen clinicians from each of 13 hospitals (1 per ICU) responded. Surveyed hospitals had median of 560 (interquartile range [IQR]: 232, 1,200) beds. ICU had a median of 9 (IQR: 7, 12) beds and treated 40 (IQR: 20, 67) patients per month. Many ICU had ≥1 staff member with some formal critical care training (n = 9, 69%) or who completed Fundamental Critical Care Support (n = 7, 54%) or Advanced Cardiac Life Support (n = 9, 69%) courses. Only 2 ICU (15%) used any kind of checklists for acute resuscitation. Ten (77%) ICU listed lack of trained staff as the most important barrier to improving the care and outcomes of critically ill patients. Conclusions: In a convenience sample of 13 ICU from LMIC, specialty-trained staff and standardized processes of care such as checklists are frequently lacking. ICU needs-assessment evaluations should be expanded in LMIC as a global priority, with the goal of creating and evaluating context-appropriate checklists for ICU best practices. | URI: | https://open.uns.ac.rs/handle/123456789/6988 | ISSN: | 22118160 | DOI: | 10.1016/j.gheart.2014.08.002 |
Appears in Collections: | MDF Publikacije/Publications |
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