马拉维医疗病房的重症护理能力和护理包:一个横截面研究
Emilia Connolly1,2,3, Noel Kasomekera4,5, Paul D Sonenthal6,7,8
1, Abwenzi Pa Za Umoyo/Partners In Health, PO Box 56, Neno, Malawi. econnolly@pih.org.
BMC health services research
|October 5, 2023
概括
低收入国家的重症监护能力可以在一般医疗病房中以适度的投入实现. 这项研究强调了改善重症病患者在重症监护室 (ICU) 外的治疗结果所需的基本资源.
科学领域:
- 全球健康 全球健康
- 关键护理医学 关键护理医学
- 卫生系统研究 卫生系统研究
背景情况:
- 低收入国家 (LICs) 面临着严重疾病的高负担,需要扩大传统重症监护室 (ICU) 以外的重症监护能力.
- 有限的数据存在于LIC中非ICU设置中的重症监护提供,阻碍改善患者结果的努力.
- 一般医疗病房代表了在资源有限的环境中提供重症监护的潜在环境.
研究的目的:
- 评估马拉维地区和中央医院医疗病房对重症监护的准备情况.
- 确定在马拉维非ICU环境中提供关键护理所需的障碍和基本投入.
- 为了比较地区和中央医院医疗病房之间的重症监护能力.
主要方法:
- 2020年进行的马拉维紧急和重症监护 (MECC) 横截面调查的二次分析.
- 包括马拉维9个地区和4个中央公共部门医院.
- 评估人员,基础设施,设备和系统,使用基本护理包和通过费舍尔精确测试进行比较.
主要成果:
- 没有医疗病房符合世界重症监护医学联合会 (WFSICCM) 对1级重症监护的定义.
- 与中央医院相比,地区医院的医疗病房报告更频繁的缺货 (29%vs6%) 和人员短缺 (40%vs29%).
- 中心医院病房报告了更高的培训障碍 (68%与45%相比),在医院类型之间没有观察到统计学上显著的差异.
结论:
- 尽管有资源缺口,但在医疗病房提供必要的拯救生命的重症监护是可以做到的,只需适度的资源投入.
- 该研究确定了干预的关键领域,以加强在低收入国家的非ICU环境中的重症监护服务.
- 结果可以为提高资源有限的医疗保健系统的重症监护能力提供有针对性的策略和资源配置.
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