scholarly journals Midwives’ and Medical professionals’ perspectives of collaborative practice at Queen Elizabeth Central Hospital Maternity Unit, Malawi: The discovery phase of an appreciative inquiry project

2020 ◽  
Vol 32 (1) ◽  
pp. 13-18
Author(s):  
Elizabeth Chodzaza
Keyword(s):  
Appreciative Inquiry ◽  
Theoretical Perspective ◽  
Collaborative Practice ◽  
Medical Professionals ◽  
Central Hospital ◽  
Intrapartum Care ◽  
Collaborative Practices ◽  
Innovative Strategies ◽  
Discovery Phase ◽  
Queen Elizabeth Central Hospital

BackgroundThis paper reports on part of a larger study, the aim of which was to develop an intervention to collaboratively develop innovative strategies to promote effective collaborative practices among midwives and medical professionals working in intrapartum care unit. Collaborative practice is a critical marker for success in improving quality of maternity care. To date, there has been limited exploration of collaborative practices between midwives and medical professionals working in intrapartum care from the African perspective. Aim This paper reports findings of the discovery phase of appreciative inquiry (AI) set out tounderstand the perspectives of midwives and medical professionals on collaborative practices at Queen Elizabeth Central Hospital labour and delivery ward in Malawi. MethodsThe study used an exploratory qualitative approach framed in an Appreciative Inquiry theoretical perspective. Appreciative Inquiry consists of four phases :(discovery, dream, design and destiny).The discovery phase consisted of 16 in-depth interviews and 2 focus group discussions among purposively selected midwives (4 nurse midwives, 2 midwifery unit matrons) and medical professionals (2 obstetricians, 4 registrars, 2 intern doctors, 2 clinical officers) working in the labour ward. All interviews and discussions were audiotaped and transcribed verbatim. Data were analysed using thematic analysis. ResultsFive dominant themes emerged: collaborative breakdown, benefits of collaboration, the importance of positive and respectful attitude, barriers to effective collaborative practices and strategies to improve collaborative practice. Conclusion/RecommendationsAligning the perspectives of the members of the two disciplines is significant to effective implementation of collaborative intrapartum care. Participants demonstrated that there is increased parallel working of midwives and doctors at QECH. This is not professionally healthy. Therefore, putting together the viewpoints of the professions to create a mutually agreeable professional framework of collaborative intrapartum practice is significant. Additionally, there is an obvious need to address the professional concerns of both disciplines.

scholarly journals Early doxorubicin cardiotoxicity in Malawian children admitted to Queen Elizabeth Central Hospital, Malawi

2021 ◽  
Author(s):  
Dominic Moyo ◽  
Yamikani Chimalizeni ◽  
George Chagaluka ◽  
Clifford G. Banda ◽  
Elizabeth M. Molyneux
Keyword(s):  
Central Hospital ◽  
Doxorubicin Cardiotoxicity ◽  
Queen Elizabeth Central Hospital

scholarly journals Associative Factors for Birth Asphyxia at Queen Elizabeth Central Hospital—Malawi

2017 ◽  
Vol 05 (05) ◽  
pp. 22-31 ◽  
Author(s):  
Edith Tewesa ◽  
Ellen Chirwa ◽  
Maureen Daisy Majamanda ◽  
Alfred Maluwa ◽  
Angela Chimwaza
Keyword(s):  
Birth Asphyxia ◽  
Central Hospital ◽  
Queen Elizabeth Central Hospital

Histological Phenotype of Breast Cancer in Indigenous Malawian Women Presenting at Queen Elizabeth Central Hospital in Malawi

2017 ◽  
Vol 06 (01) ◽  
Author(s):  
Nelson Chimbiya ◽  
Clemence Marimo ◽  
Trevor Kaile ◽  
Tamiwe Tomoka ◽  
Steve Kamiza ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Central Hospital ◽  
Histological Phenotype ◽  
Queen Elizabeth Central Hospital

scholarly journals The significant gap between international standards and stroke management practices at Queen Elizabeth Central Hospital (Malawi): An audit report

2019 ◽  
Vol 31 (4) ◽  
pp. 249-255 ◽  
Author(s):  
Yohane Gadama
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Acute Stroke ◽  
Cardiovascular Risk Factors ◽  
Management Practices ◽  
Vital Signs ◽  
Central Hospital ◽  
Stroke Management ◽  
The Mean ◽  
Queen Elizabeth Central Hospital

BackgroundThe Queen Elizabeth Central Hospital (QECH) is preparing to set up the first stroke unit in Blantyre, Malawi. We conducted this audit to assess current stroke management practices and outcomes at QECH and identify priority areas for intervention.MethodsFrom April to June 2018, we prospectively enrolled patients with acute stroke and collected data on clinical presentation, cardiovascular risk factors, investigations and interventions, in-hospital outcomes, and follow-up plans after discharge. The American Heart Association/American Stroke Association (AHA/ASA) guidelines were used as the standard of care for comparison.ResultsFifty patients with acute stroke were enrolled (46% women, 54% men). The mean age was 63.1 years (95% CI: 59.7–66.6). The diagnosis of stroke was based on the World Health Organization criteria. The diagnosis was made within 24 hours of admission in 19 patients (38%). Acute revascularisation therapy was not available. Forty-eight patients (96%) had their vital signs checked at baseline and <10% had their vital signs checked more than three times within the first 24 hours. Essential blood tests including random blood sugar (RBS), full blood count (FBC), urea/creatinine, and lipid profiles were performed in 72%, 68%, 48%, and 4%, respectively. An electrocardiogram was performed on 34 patients (68%). Blood pressure on admission was >140/90 mmHg in 34 patients (68%), including 4 with values >220/120 mmHg. Nine patients had an RBS >10 mmol/L and four received insulin. Prophylaxis for deep venous thrombosis was offered to 12 patients (24%). Aspiration pneumonia was reported in 16 patients (32%) and was the most common hospital complication. The mean duration of hospitalisation was 10.4 days (95% CI: 5.6–15.2), and case fatality was 18%. The modified Rankin scale at discharge was ≤2 in 32% of patients. Only four patients (8%) were transferred to a rehabilitation centre. At the time of discharge, only 32% of patients received education on stroke.ConclusionAcute stroke care is less than optimal in this setting. Simple interventions such as reducing the delay in making a stroke diagnosis, early swallow assessments, and closer monitoring of vital signs could make a significant difference in stroke outcome. Furthermore, treating cardiovascular risk factors and setting up health education programmes to improve secondary prevention represent key priorities.

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