Improving Knowledge and Skills of Healthcare Professionals in Limited Resources Disaster Settings: The 12 Year Experience of the Master’s Course in Global Health: Disaster Medicine

AbstractBackground:The Advanced Life Support in Obstetrics (ALSO®) program is a highly structured, evidence-based, two-day course designed to provide healthcare professionals with the knowledge and skills to manage the emergency conditions that can occur during childbirth.Objectives:To document the number of ALSO®-trained clinicians and instructors in the United States and internationally and to promote ALSO® training among prehospital and disaster medicine professionals.Methods:Records maintained by the American Academy of Family Physicians (AAFP) for each country where ALSO® is taught were reviewed for: (1) the years and locations of the ALSO® courses; (2) the number of ALSO®-trained caregivers; and (3) the number of ALSO® instructors.Results:Between 1991 and 2005, 54,071 ALSO®-trained caregivers and 2,251 instructors have completed provider and instructor ALSO® courses in 25 countries. Of these, 17,755 caregivers and 1,220 instructors are from outside the United States.Conclusion:The ALSO® program is a popular, multi-disciplinary course for preparing maternity caregivers to manage obstetric emergencies. Limited evidence suggests it can be effective and efficient in enhancing the knowledge and skills of prehospital and disaster medicine clinicians. Hong Kong provides a model in which emergency physicians have taken the lead in promoting the ALSO® course. As the ALSO® program expands, additional research is needed to assess its impact on educational and health outcomes.

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Precision Health in Disaster Medicine and Global Public Health

Prehospital and Disaster Medicine ◽

10.1017/s1049023x18001061 ◽

2018 ◽

Vol 33 (6) ◽

pp. 565-566 ◽

Cited By ~ 1

Author(s):

Ronak B. Patel

Keyword(s):

Public Health ◽

Global Health ◽

Precision Medicine ◽

Vulnerable Populations ◽

Disaster Medicine ◽

Limited Resources ◽

Global Public Health ◽

Publication Type ◽

New Approaches ◽

Precision Health

AbstractCurrent debates about precision medicine take different perspectives on its relevance and value in global health. The term has not yet been applied to disaster medicine or humanitarian health, but it may hold significant value. An interpretation of the term for global public health and disaster medicine is presented here for application to vulnerable populations. Embracing the term may drive more efficient use and targeting of limited resources while encouraging innovation and adopting the new approaches advocated in current humanitarian discourse.PatelRB.Precision health in disaster medicine and global public health.Prehosp Disaster Med.2018;33(6):565–566.

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Medical Ethics during the COVID-19 Pandemic

Acta Medica ◽

10.32552/2021.actamedica.505 ◽

2021 ◽

pp. 1-10

Author(s):

Sevim Coşkun ◽

Nüket Örnek Büken

Keyword(s):

Healthcare Professionals ◽

Human Life ◽

Action Plan ◽

Disaster Medicine ◽

Ethical Principles ◽

Duty Of Care ◽

Protective Measures ◽

Life Threatening ◽

Correct Application ◽

Difficult Situations

WHO states five ethical principles for the care of patients with COVID-19: Equal moral respect, duty of care, non-abandonment, protection of the community, and confidentiality. Healthcare professionals might have to make difficult decisions such as selecting patients and withholding or withdrawing mechanical ventilation of critically ill patients. In such difficult situations, a well-prepared action plan which considers ethical principles and prioritizes both public health and the safety of healthcare professionals, can help them. In this case, the development of an effective pandemic action plan, together with a triage plan based on emergency and disaster medicine is necessary. The only parameter of selection in this plan must be the correct application of triage, which respects every human life and depends on the criteria of clinical suitability. In this context, the fundamental ethical principles and human rights must be considered when allocating resources and prioritizing patients. Additionally, all protective measures for healthcare professionals must be taken, including all necessary equipment being adequately provided. If healthcare professionals become infected or face a life-threatening risk, then their obligations will be limited. Therefore, it is necessary to realize these limitations which may arise while providing appropriate health services.

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Exploring ambivalent oxygen machine–people–world relations through the lens of postphenomenology

Journal of Material Culture ◽

10.1177/1359183518799521 ◽

2018 ◽

Vol 23 (4) ◽

pp. 426-447 ◽

Cited By ~ 1

Author(s):

Megan Wainwright

Keyword(s):

South Africa ◽

Global Health ◽

Oxygen Therapy ◽

Heart Diseases ◽

Health Technology ◽

Limited Resources ◽

The Political ◽

Philosophical Approach ◽

The Face ◽

The Relationship

Technologies for medicinal oxygen delivery at home are increasingly part of the global health technology landscape in the face of rising rates of chronic lung and heart diseases. From the mere notion of harvesting and privatizing oxygen from the atmosphere to its status as both dangerous and therapeutic, and finally to its capacity to both extend and limit life, oxygen as therapy materializes its status as an ambivalent object in global health. This analysis of ethnographic material from Uruguay and South Africa on the experience of home oxygen therapy is guided by philosopher Don Ihde’s postphenomenology – a pragmatic philosophical approach for analysing the relationships between humans and technologies. Participants related to their oxygen devices as limiting-enablers, as markers of illness and measures of recovery, and as precious and limited resources. Oxygen was materialized in many forms, each with their own characteristics shaping the ‘amplification/reduction’ character of the relationship as well as the degree to which the devices became ‘transparent’ to their users. Ihde’s four types of human–technology relations – embodiment, hermeneutic, alterity and background relations – are at play in the multistability of oxygen. Importantly, the lack of technological ‘transparency’, in Ihde’s sense of the term, reflects not only the materiality of oxygen but inequality too. While postphenomenology adds a productive material and technological flavour to phenomenology, the author argues that a critical postphenomenology is needed to engage with the political-economy of human–oxygen technology relations.

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How can healthcare professionals address poor health service utilisation among refugees after resettlement in Australia? A narrative systematic review of recent evidence

Australian Journal of Primary Health ◽

10.1071/py18120 ◽

2019 ◽

Vol 25 (3) ◽

pp. 205

Author(s):

Jamuna Parajuli ◽

Dell Horey

Keyword(s):

Health Service ◽

Health Services ◽

Cultural Competency ◽

Communication Skills ◽

Healthcare Professionals ◽

Qualitative Studies ◽

Service Utilisation ◽

Knowledge And Skills ◽

Service Barriers ◽

Synthesis Approach

This systematic narrative review of qualitative studies examined health service barriers and facilitators in Australia for refugees after resettlement. Twelve qualitative studies published between 2006 and 2017 involving more than 500 participants were included in the review. Approximately half of all participants were healthcare professionals. A meta-synthesis approach was used to compare and combine findings from across studies. Few facilitators were identified. Barriers to accessing health services were commonly attributed to refugees, but several barriers were associated with healthcare professionals and health services. Barriers attributed to healthcare professionals included gaps in knowledge and skills; poor cultural competency; poor communication skills; and time constraints. Understanding such barriers is the first step in developing strategies to overcome them. The skills and knowledge of healthcare professionals are important to facilitating access to healthcare among this vulnerable population.

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Leveraging massive open online courses to expand quality of healthcare education to health practitioners in Rwanda

BMJ Open Quality ◽

10.1136/bmjoq-2018-000532 ◽

2019 ◽

Vol 8 (4) ◽

pp. e000532 ◽

Cited By ~ 1

Author(s):

Kirstin Woody Scott ◽

Theophile Dushime ◽

Vincent Rusanganwa ◽

Liana Woskie ◽

Clint Attebery ◽

...

Keyword(s):

Patient Safety ◽

Global Health ◽

Healthcare Professionals ◽

Healthcare Delivery ◽

Quality Of Healthcare ◽

Lessons Learned ◽

Online Course ◽

Massive Open Online ◽

District Hospitals

Improving the quality of healthcare delivery is increasingly a global health priority. However, quality improvement training opportunities that provide theoretical foundations and basic skills for patient safety and other quality initiatives have been limited or historically out of reach, especially in low-and-middle income countries (LMICs). To address this gap, the Harvard Initiative on Global Health Quality (HIGHQ) created and launched a massive open online course (MOOC) in 2014 focused on patient safety and quality of care using the edX platform. More than 30 000 students from across 195 countries registered for the online course. This paper summarises an innovative educational partnership between the course team and one of these countries, Rwanda, to develop a blended-learning model to bolster participation in this new course among Rwandan healthcare professionals. Although a small country, Rwanda was among the top performing countries for attracting course registrants and was the leading country for the proportion of enrollees who ultimately completed the course. Further, half (21 of 42) of Rwanda’s district hospitals opted to appoint a PH555x course facilitator at their site to help lead regular meetings and discussions about the course content at their facility. The majority of Rwandan enrollees were health professionals (63%) and 81% reported that PH555x was their first experience taking an online course. Among those participating in the ‘flipped’ component at hospital sites, 94% reported that the course helped them to think of specific ways to improve healthcare quality at their facility. In this paper, we describe this innovative public–private educational model, challenges to implementation and lessons learned that may be helpful for future MOOC developers who wish to augment learning opportunities among healthcare professionals in LMICs.

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Bedside Surgical Tracheostomy in the Intensive Care Unit during Covid-19 Pandemic

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420947767 ◽

2020 ◽

pp. 000348942094776

Author(s):

Filippo Di Lella ◽

Edoardo Picetti ◽

Giovanni Ciavarro ◽

Giovanni Pepe ◽

Laura Malchiodi ◽

...

Keyword(s):

Healthcare Workers ◽

Healthcare Professionals ◽

Distress Syndrome ◽

Optimal Allocation ◽

Northern Italy ◽

University Hospital ◽

Limited Resources ◽

Tertiary Referral ◽

Surgical Tracheostomy ◽

Percutaneous Procedures

Objectives: To describe Otolaryngologists’ perspective in managing COVID-19 patients with acute respiratory distress syndrome (ARDS) requiring tracheostomy in the ICUs during the pandemic peak in a dramatic scenario with limited resources. Setting: Tertiary referral university hospital, regional hub in northern Italy during SARS CoV 2 pandemic peak (March 9th to April 10th, 2020). Methods: Technical description of open bedside tracheostomies performed in ICUs on COVID-19 patients during pandemic peak with particular focus on resource allocation and healthcare professionals coordination. A dedicated “airway team” was created in order to avoid transportation of critically ill patients and reduce facility contamination. Results: During the COVID-19 pandemic, bedside minimally invasive tracheostomy in the ICU was selected by the Authors over conventional surgical technique or percutaneous procedures for both technical and operational reasons. Otolaryngologists’ experience derived from direct involvement in 24 tracheostomies is reported. Conclusions: Tracheostomies on COVID-19 patients should be performed in a safe and standardized setting. The limited resources available in the pandemic peak required meticulous organization and optimal allocation of the resources to grant safety of both patients and healthcare workers.

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404: No Pain Labor N’ Delivery: a collaborative educational-global health initiative to transform current knowledge and skills into better maternal and neonatal outcomes

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2013.10.437 ◽

2014 ◽

Vol 210 (1) ◽

pp. S204-S205 ◽

Cited By ~ 2

Author(s):

Ling Qun Hu ◽

Lynn Yee ◽

Emily Miller ◽

Francis Stellaccio ◽

Cynthia Wong

Keyword(s):

Global Health ◽

Current Knowledge ◽

Neonatal Outcomes ◽

Global Health Initiative ◽

Knowledge And Skills ◽

Health Initiative ◽

Maternal And Neonatal Outcomes

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The Impact of Experience, Length of Service, and Workplace Preparedness in Physicians’ Readiness in the Response to Disasters

Journal of Clinical Medicine ◽

10.3390/jcm9103328 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3328 ◽

Cited By ~ 5

Author(s):

Krzysztof Goniewicz ◽

Mariusz Goniewicz ◽

Frederick M. Burkle ◽

Amir Khorram-Manesh

Keyword(s):

Disaster Management ◽

Disaster Preparedness ◽

Healthcare Professionals ◽

Disaster Medicine ◽

Management Approach ◽

Length Of Service ◽

Frontline Workers ◽

Medical Centers ◽

Perceived Preparedness ◽

The Impact

With an increasing number of natural and man-made disasters, the need for preparedness in all levels of management is obvious. Among healthcare professionals responding to these emergencies, physicians are of particular importance due to their significant roles as leaders and frontline workers in minimizing morbidity and mortality of the affected population. This study analyses the preparedness of 549 physicians from all medical centers in Lublin, Poland to formulate their observations, suggestions, and recommendations concerning the improvement of the chain of response in disaster management. The results of this study show that the perceived preparedness of physicians for disaster management and response is not as high as it should be, and the majority of the respondents perceived their disaster preparedness insufficient. Training of physicians in disaster management and principles of disaster medicine is needed, by focusing on the specificity of rescue response to emergencies following disasters, and medical and non-medical aspects of the response with particular emphasis on a management approach covering all hazards.

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