Emergency and critical care services in Tanzania: a survey of ten hospitals.
Emergency and critical care services in Tanzania: a survey of ten hospitals.
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DOI：
10.1186/1472-6963-13-140
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发表时间：
2013-04-16
影响因子：
2.8
通讯作者：
Konrad D
中科院分区：
文献类型：
--
作者：
Baker T;Lugazia E;Eriksen J;Mwafongo V;Irestedt L;Konrad D
虽然世界上所有国家都需要为患有严重可逆性疾病的患者提供高质量的护理，但急诊和重症监护往往是低收入国家卫生系统中最薄弱的部分之一。我们评估了坦桑尼亚急诊和重症护理的资源结构和可用性，以确定改善这一被忽视专业护理的优先事项。使用结构化数据收集工具对坦桑尼亚四个地区的10家医院进行了评估。根据文献和专家意见制定的标准对质量进行评估。在基础设施、日常工作和培训方面发现了重大缺陷。只有30%的医院为成人和儿科病人设有急诊室。7个区和地区医院中没有一个设有成人分诊区或重症监护室。只有40%的医院有正式的成人分诊系统，只有不到三分之一的危重病人每天被临床医生诊治一次以上。80%的医院没有受过成人分诊或重症监护培训的工作人员。相比之下，医院可提供急诊和重症监护所需的大多数设备和药物（中位数分别为90%和100%）。转诊/私立医院的总体资源可用性（中位数为89.7%）往往高于区/区域医院（中位数为70.6%）。坦桑尼亚的医院缺乏急诊和重症监护所需的许多设施。特别的弱点是基础设施、常规和训练，而药品和设备的供应总体上是好的。应优先制定政策，改善医院系统，以照顾急诊和危重病人。
While there is a need for good quality care for patients with serious reversible disease in all countries in the world, Emergency and Critical Care tends to be one of the weakest parts of health systems in low-income countries. We assessed the structure and availability of resources for Emergency and Critical Care in Tanzania in order to identify the priorities for improving care in this neglected specialty. Ten hospitals in four regions of Tanzania were assessed using a structured data collection tool. Quality was evaluated with standards developed from the literature and expert opinion. Important deficits were identified in infrastructure, routines and training. Only 30% of the hospitals had an emergency room for adult and paediatric patients. None of the seven district and regional hospitals had a triage area or intensive care unit for adults. Only 40% of the hospitals had formal systems for adult triage and in less than one third were critically ill patients seen by clinicians more than once daily. In 80% of the hospitals there were no staff trained in adult triage or critical care. In contrast, a majority of equipment and drugs necessary for emergency and critical care were available in the hospitals (median 90% and 100% respectively. The referral/private hospitals tended to have a greater overall availability of resources (median 89.7%) than district/regional hospitals (median 70.6). Many of the structures necessary for Emergency and Critical Care are lacking in hospitals in Tanzania. Particular weaknesses are infrastructure, routines and training, whereas the availability of drugs and equipment is generally good. Policies to improve hospital systems for the care of emergency and critically ill patients should be prioritised.
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DOI：
10.1136/bmj.d4847
发表时间：
2011-08-08
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Crump JA;Gove S;Parry CM
通讯作者：
Parry CM
影响因子：
15.8
作者：
Cheng, Allen C.;West, T. Eoin;Peacock, Sharon J.
通讯作者：
Peacock, Sharon J.
影响因子：
168.9
作者：
Liu, Li;Johnson, Hope L.;Black, Robert E.
通讯作者：
Black, Robert E.
DOI：
10.1007/s12630-010-9381-6
发表时间：
2010-11
影响因子：
4.2
作者：
Merry, Alan F.;Cooper, Jeffrey B.;Soyannwo, Olaitan;Wilson, Iain H.;Eichhorn, John H.
通讯作者：
Eichhorn, John H.
影响因子：
15.1
作者：
Baelani, Inipavudu;Jochberger, Stefan;Duenser, Martin W.
通讯作者：
Duenser, Martin W.