Broccoli Morgan C, Dixon Julia, Skarpiak Branden, Phiri Godfrey, Muck Andrew E, Calvello Hynes Emilie J
Boston Medical Center, Department of Emergency Medicine, Boston, MA, USA.
University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, CO, USA.
Afr J Emerg Med. 2021 Mar;11(1):140-143. doi: 10.1016/j.afjem.2020.09.011. Epub 2020 Oct 17.
In 2013, the Zambian Ministry of Health identified action priorities for strengthening their emergency care system; one of these priorities was emergency care training for healthcare providers. To rapidly train the existing cadre of frontline providers, trainings were implemented in multiple provinces using the World Health Organization's Basic Emergency Care (BEC) course. The BEC course is open-access and emphasizes a practical syndrome-based approach to critical emergency conditions. This paper describes the first reported larger scale educational intervention of the BEC course in 7 provinces of Zambia.
Course delivery occurred at seven Zambian hospitals selected by the Ministry of Health over a 1 year period. Participant emergency care knowledge was assessed pre- and post-course with a 25-question multiple choice exam. Participant confidence levels related to emergency care provision and emergency care skills were assessed pre- and post-course using a Likert scale survey.
Overall, 210 participants were trained at 7 sites. Participants demonstrated significant improvements in their multiple-choice exam scores; the overall pre-course mean was 61.47, and the post-course mean was 79.87 (p < 0.0001). Self-reported confidence in the care of ill and injured adults and children increased after taking the course, and participants generally agreed that the BEC course was highly valuable and applicable to local needs.
Implementation of the WHO's BEC course at seven hospitals throughout Zambia led to improvement in the participants' emergency care knowledge and confidence levels at all sites. The BEC course has the potential to be implemented in a nationwide initiative but would require allocation of significant human and physical resources. Additional work evaluating patient outcomes and long-term participant educational outcomes is needed.
2013年，赞比亚卫生部确定了加强其急诊护理系统的行动重点；其中一个重点是为医疗服务提供者提供急诊护理培训。为了快速培训现有的一线医疗服务人员，在多个省份采用世界卫生组织的基本急诊护理（BEC）课程开展了培训。BEC课程是开放获取的，强调针对严重紧急情况采用基于综合征的实用方法。本文描述了赞比亚7个省份首次报告的BEC课程大规模教育干预情况。
课程在赞比亚卫生部选定的7家医院进行，为期1年。通过25道选择题考试在课程前后对参与者的急诊护理知识进行评估。使用李克特量表调查在课程前后评估参与者与急诊护理提供和急诊护理技能相关的信心水平。
总体而言，7个地点共培训了210名参与者。参与者在选择题考试成绩上有显著提高；课程前的总体平均分为61.47，课程后的平均分为79.87（p < 0.0001）。参加课程后，自我报告的对患病和受伤成人及儿童护理的信心有所增加，参与者普遍认为BEC课程非常有价值且适用于当地需求。
在赞比亚各地的7家医院实施世界卫生组织的BEC课程，使所有地点的参与者的急诊护理知识和信心水平都得到了提高。BEC课程有潜力在全国范围内开展，但需要分配大量的人力和物力资源。还需要开展更多评估患者结果和参与者长期教育成果的工作。
