Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital-Reference-Cited by-同舟云学术

Effectiveness of a Pediatric Emergency Medicine Curriculum in a Public Tanzanian Referral Hospital

Published:2019-12-19 Issue:1 Volume:21 Page:134-140
ISSN:1936-900X
Container-title:Western Journal of Emergency Medicine
language:
Short-container-title:WestJEM

Author:

Chen Carol¹,Werne Alexander²,Osborn Katharine³,Vo Holly²,George Upendo⁴,Sawe Hendry⁴,Addo Newton⁵,Cruz Andrea⁶

Affiliation:

1. University of California, San Francisco, Section of Pediatric Emergency Medicine, Department of Emergency Medicine, San Francisco, California

2. University of California, San Francisco, Department of Pediatrics, San Francisco, California

3. University of California, San Francisco, Section of Pediatric Emergency Medicine, Department of Emergency Medicine, San Francisco, California; University of Utah, Division of Emergency Medicine, Department of Pediatrics, Salt Lake City, Utah

4. Muhimbili National Hospital, Department of Emergency Medicine, Dar Es Salaam, Tanzania

5. University of California, San Francisco, Department of Medicine, Clinical Pharmacology Program, San Francisco, California; University of California, San Francisco, Department of Emergency Medicine, San Francisco, California

6. University of California, San Francisco, Department of Emergency Medicine, San Francisco, California

Abstract

Introduction: The World Health Organization recently recognized the importance of emergency and trauma care in reducing morbidity and mortality. Training programs are essential to improving emergency care in low-resource settings; however, a paucity of comprehensive curricula focusing specifically on pediatric emergency medicine (PEM) currently exists. The African Federation for Emergency Medicine (AFEM) developed a PEM curriculum that was pilot-tested in a non-randomized, controlled study to evaluate its effectiveness in nurses working in a public Tanzanian referral hospital. Methods: Fifteen nurses were recruited to participate in a two-and-a-half-day curriculum of lectures, skill sessions, and simulation scenarios covering nine topics; they were matched with controls. Both groups completed pre- and post-training assessments of their knowledge (multiple-choice test), self-efficacy (Likert surveys), and behavior. Changes in behavior were assessed using a binary checklist of critical actions during observations of live pediatric resuscitations. Results: Participant-rated pre-training self-efficacy and knowledge test scores were similar in both control and intervention groups. However, post-training, self-efficacy ratings in the intervention group increased by a median of 11.5 points (interquartile range [IQR]: 6-16) while unchanged in the control group. Knowledge test scores also increased by a median of three points (IQR: 0-4) in the nurses who received the training while the control group’s results did not differ in the two periods. A total of 1192 pediatric resuscitation cases were observed post-training, with the intervention group demonstrating higher rates of performance of three of 27 critical actions. Conclusion: This pilot study of the AFEM PEM curriculum for nurses has shown it to be an effective tool in knowledge acquisition and improved self-efficacy of pediatric emergencies. Further evaluation will be needed to assess whether it is currently effective in changing nurse behavior and patient outcomes or whether curricular modifications are needed.

Publisher

Western Journal of Emergency Medicine

Subject

General Medicine,Emergency Medicine

Reference25 articles.

1. Hsiao M, Morris SK, |Malhotra A, et al. Time-critical mortality conditions in low-income and middle-income countries. Lancet. 2013;381(9871):993-4.

2. Reynolds TA, Sawe H, Rubiano AM, Shin SD, Wallis L, Mock CN. (2017). Chapter 13: Strengthening health systems to provide emergency care. In: Jamison DT, Gelband H, Horton S (Eds.), Disease Control Priorities: Improving Health and Reducing Poverty (247-266). 3rd edition. Washington, D.C.: The International Bank for Reconstruction and Development/The World Bank.

3. Director-General. Emergency care systems for universal health coverage: ensuring timely care for the acutely ill and injured. 2019. Available at: https://www.physiospot.com/2019/05/30/new-who-emergency-and-trauma-care-resolution/. Accessed October 31, 2019.

4. Wang P, Li NP, Gu YF, et al. Comparison of severe trauma care effect before and after advanced trauma life support training. Chin J Traumatol. 2010;13(6):341-4.

5. Petroze RT, Byiringiro JC, Ntakiyiruta G, et al. Can focused trauma education initiatives reduce mortality or improve resource utilization in a low-resource setting? World J Surg. 2015;39(4):926-33.

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