Establishment of a high-dependency unit in Malawi

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Open access articles:
1052
Annotations added:
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Establishment of a high-dependency unit in Malawi


JournalBMJ Global Health
Article typeJournal research article – Other
Publication date – Oct – 2020
Authors – Ben Morton, Ndaziona Peter Banda, Edna Nsomba, Clara Ngoliwa, Sandra Antoine, Joel Gondwe, Felix Limbani, Marc Yves Romain Henrion, James Chirombo, Tim Baker, Patrick Kamalo, Chimota Phiri, Leo Masamba, Tamara Phiri, Jane Mallewa, Henry Charles Mwandumba, Kwazizira Samson Mndolo, Stephen Gordon, Jamie Rylance
KeywordsAnaesthesia, covid-19, ITU
Open access – Yes
SpecialityAnaesthesia
World region Southern Africa
Country: Malawi
Language – English
Submitted to the One Surgery Index on December 12, 2020 at 11:34 am
Abstract:

Adults admitted to hospital with critical illness are vulnerable and at high risk of morbidity and mortality, especially in sub-Saharan African settings where resources are severely limited. As life expectancy increases, patient demographics and healthcare needs are increasingly complex and require integrated approaches. Patient outcomes could be improved by increased critical care provision that standardises healthcare delivery, provides specialist staff and enhanced patient monitoring and facilitates some treatment modalities for organ support. In Malawi, we established a new high-dependency unit within Queen Elizabeth Central Hospital, a tertiary referral centre serving the country’s Southern region. This unit was designed in partnership with managers, clinicians, nurses and patients to address their needs. In this practice piece, we describe a participatory approach to design and implement a sustainable high-dependency unit for a low-income sub-Saharan African setting. This included: prospective agreement on remit, alignment with existing services, refurbishment of a dedicated physical space, recruitment and training of specialist nurses, development of context-sensitive clinical standard operating procedures, purchase of appropriate and durable equipment and creation of digital clinical information systems. As the global COVID-19 pandemic unfolded, we accelerated unit opening in anticipation of increased clinical requirement and describe how the high-dependency unit responded to this demand.

OSI Number – 20794

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