Sakr Carine J, Assaf Sara A, Fakih Lina, Dakroub Saada, Rahme Diana, Musharrafieh Umayya, Khater Beatrice, Naous Jihane, Romani Maya, Tannous Joseph, Zahreddine Nada, Fakhreddine Mohammad, Itani Mira, Zalaquett Nader, Honein Gladys
Employee Health Unit, Department of Family Medicine, American University of Beirut, Beirut 1107 2020, Lebanon.
Department of Family Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon.
Healthcare (Basel). 2024 Jan 26;12(3):321. doi: 10.3390/healthcare12030321.
The COVID-19 pandemic strained healthcare systems around the world. This study aims to understand the preparedness of private remote hospitals in Lebanon to respond to the pandemic and evaluate the impact of inter-hospital collaborations on the hospitals' readiness.
A multi-centered study was conducted between August 2020 and June 2021 in ten Lebanese private remote hospitals based on a mixed-methods embedded approach where the quantitative supported the qualitative. Through the AUB-USAID (American University of Beirut-United States Agency for International Development) COVID-19 project, these hospitals received personal protective equipment and medical equipment in addition to COVID-19-related training using the Train-the-Trainer model. The quantitative part used knowledge and evaluation questionnaires and a pre-post-intervention hospital preparedness checklist. The qualitative approach adopted semi-structured interviews with a purposive sample from key hospital personnel. Quantitative data were analyzed using SPSS version 27, and a -value of <0.05 was considered to be statistically significant. For the qualitative data, a thematic analysis was performed by adopting the six-phase process described by Braun and Clarke.
Of the 393 healthcare workers who attended the training and completed the evaluation questionnaire, 326 completed the pre- and post-training knowledge questionnaire. A significant improvement was observed in mean knowledge scores following training for infection control, nursing, and polymerase chain reaction sampling staff (-value < 0.001, -value < 0.001, and -value = 0.006, respectively), but not for housekeeping staff. More than 93% of the participants showed high trainer and content evaluation scores. As for the hospitals' preparedness assessments, there was a clear improvement in the pre- and post-assessment scores for each hospital, and there was a significant difference in the mean of the total scores of partner hospitals pre- and post-USAID-AUB project (-value = 0.005). These findings were supported by the qualitative analysis, where nine hospitals expressed the positive impact of the USAID-AUB intervention in improving their preparedness to respond to the COVID-19 pandemic at a critical time when it was highly needed. Despite the intervention, persistent challenges remained.
A timely and proactive collaborative program between academic/tertiary care centers and remote community hospitals that includes sharing supplies and expertise is feasible and highly effective during public health emergencies.
新冠疫情使全球医疗系统不堪重负。本研究旨在了解黎巴嫩私立偏远医院应对疫情的准备情况，并评估医院间合作对医院准备状态的影响。
2020年8月至2021年6月，在黎巴嫩的十家私立偏远医院开展了一项多中心研究，采用定量支持定性的混合方法嵌入式研究方法。通过美国贝鲁特大学-美国国际开发署（AUB-USAID）新冠项目，这些医院除了接受使用培训师培训模式的新冠相关培训外，还获得了个人防护装备和医疗设备。定量部分使用知识和评估问卷以及干预前后医院准备情况检查表。定性方法采用对关键医院人员的目的抽样进行半结构化访谈。定量数据使用SPSS 27版进行分析，P值<0.05被认为具有统计学意义。对于定性数据，采用Braun和Clarke描述的六阶段过程进行主题分析。
在参加培训并完成评估问卷的393名医护人员中，326人完成了培训前后的知识问卷。培训后，感染控制、护理和聚合酶链反应采样人员的平均知识得分有显著提高（P值分别<0.001、<0.001和=0.006），但家政人员没有。超过93%的参与者对培训师和培训内容的评价得分较高。至于医院的准备情况评估，每家医院评估前后的得分都有明显提高，美国国际开发署-美国贝鲁特大学项目前后合作医院总分的平均值有显著差异（P值=0.005）。这些结果得到了定性分析的支持，其中九家医院表示，在美国国际开发署-美国贝鲁特大学的干预下，在急需的关键时期，它们应对新冠疫情的准备状态有了积极改善。尽管进行了干预，但挑战依然存在。
在公共卫生紧急事件期间，学术/三级护理中心与偏远社区医院之间及时、积极的合作项目，包括物资和专业知识共享，是可行且高效的。
