评估莫桑比克 4 所最大医院儿科创伤护理中的关键资源差距。
Assessment of critical resource gaps in pediatric injury care in Mozambique's four largest Hospitals.
机构信息
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of the Community Health, Eduardo Mondlane University, Maputo, Mozambique.
出版信息
PLoS One. 2023 Jun 1;18(6):e0286288. doi: 10.1371/journal.pone.0286288. eCollection 2023.
BACKGROUND
Hospitals from resource-scarce countries encounter significant barriers to the provision of injury care, particularly for children. Shortages in material and human resources are seldom documented, not least in African settings. This study analyzed pediatric injury care resources in Mozambique hospital settings.
METHODS
We undertook a cross-sectional study, encompassing the country's four largest hospitals. Data was collected in November 2020 at the pediatric emergency units. Assessment of the resources available was made with standardized WHO emergency equipment and medication checklists, and direct observation of premises and procedures. The potential impact of unavailable equipment and medications in pediatric wards was assessed considering the provisions of injury care.
RESULTS
There were significant amounts of not available equipment and medications in all hospitals (ranging from 20% to 49%) and two central hospitals stood out in that regard. The top categories of not available equipment pertained to diagnosis and monitoring, safety for health care personnel, and airway management. Medications to treat infections and poisonings were those most frequently not available. There were several noteworthy and life-threatening shortcomings in how well the facilities were equipped for treating pediatric patients. The staff regarded lack of equipment and skills as the main obstacles to delivering quality injury care. Further, they prioritized the implementation of trauma courses and the establishment of trauma centers to strengthen pediatric injury care.
CONCLUSION
The country's four largest hospitals had substantial quality-care threatening shortages due to lack of equipment and medications for pediatric injury care. All four hospitals face issues that put at risk staff safety and impede the implementation of essential care interventions for injured children. Staff wishes for better training, working environments adequately equipped and well-organized. The room for improvement is considerable, the study results may help to set priorities, to benefit better outcomes in child injuries.
背景
资源匮乏国家的医院在提供创伤救治方面面临重大障碍,尤其是针对儿童。物质和人力资源的短缺很少被记录下来,尤其是在非洲环境中。本研究分析了莫桑比克医院环境中儿科创伤救治资源。
方法
我们进行了一项横断面研究,涵盖了该国四家最大的医院。数据于 2020 年 11 月在儿科急诊室收集。使用标准化的世卫组织急救设备和药物检查表以及对场所和程序的直接观察,评估可用资源。考虑到创伤救治的规定,评估了儿科病房中无法获得的设备和药物对潜在的影响。
结果
所有医院都存在大量的设备和药物短缺(从 20%到 49%不等),其中两家中心医院在这方面尤为突出。无法获得的设备主要涉及诊断和监测、医护人员安全以及气道管理。无法获得的抗感染和解毒药物最为常见。在如何为儿科患者提供治疗方面,设施配备存在许多值得关注和危及生命的缺陷。工作人员认为缺乏设备和技能是提供高质量创伤救治的主要障碍。此外,他们还优先开展创伤课程和建立创伤中心,以加强儿科创伤救治。
结论
该国四家最大的医院在儿科创伤救治方面因缺乏设备和药物而存在严重的质量威胁性短缺。四家医院都面临着危及工作人员安全和阻碍实施对受伤儿童基本救治干预的问题。工作人员希望获得更好的培训,希望工作环境得到充分装备和组织。改进的空间很大,研究结果可以帮助确定优先事项,从而改善儿童受伤的治疗效果。