Development of a short course on management of critically ill patients with acute respiratory infection and impact on clinician knowledge in resource-limited intensive care units

Janet V Diaz; Justin R Ortiz; Paula Lister; Nahoko Shindo; Neill K J Adhikari; WHO Critical Care Training Short Course collaborators

doi:10.1111/irv.12569

Development of a short course on management of critically ill patients with acute respiratory infection and impact on clinician knowledge in resource-limited intensive care units

Influenza Other Respir Viruses. 2018 Sep;12(5):649-655. doi: 10.1111/irv.12569. Epub 2018 May 26.

Authors

Janet V Diaz¹, Justin R Ortiz², Paula Lister³, Nahoko Shindo¹, Neill K J Adhikari⁴; WHO Critical Care Training Short Course collaborators

Affiliations

¹ Infectious Hazard Management, Health Emergency Programme, World Health Organization, Geneva 27, Switzerland.
² Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
³ Paediatric Critical Care Unit, Sunshine Coast University Hospital, Birtinya, Qld, Australia.
⁴ Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada.

Abstract

Background: The 2009 influenza A (H1N1) pandemic caused surges of patients in intensive care units (ICUs) in resource-limited settings. Several Ministries of Health requested clinical management guidance from the World Health Organization (WHO), which had not previously developed guidance regarding critically ill patients.

Objective: To assess the acceptability and impact on knowledge of a short course about the management of critically ill patients with acute respiratory infections complicated by sepsis or acute respiratory distress syndrome delivered to clinicians in resource-limited ICUs.

Methods: Over 4 years (2009-2013), WHO led the development, piloting, implementation and preliminary evaluation of a 3-day course that emphasized patient management based on evidence-based guidelines and used interactive adult-learner teaching methodology. International content experts (n = 35) and instructional designers contributed to development. We assessed participants' satisfaction and content knowledge before and after the course.

Results: The course was piloted among clinicians in Trinidad and Tobago (n = 29), Indonesia (n = 38) and Vietnam (n = 86); feedback from these courses contributed to the final version. In 2013, inaugural national courses were delivered in Tajikistan (n = 28), Uzbekistan (n = 39) and Azerbaijan (n = 30). Participants rated the course highly and demonstrated increased immediate content knowledge after (vs before) course completion (P < .001).

Conclusions: We found that it was feasible to create and deliver a focused critical care short course to clinicians in low- and middle-income countries. Collaboration between WHO, clinical experts, instructional designers, Ministries of Health and local clinician-leaders facilitated course delivery. Future work should assess its impact on longer-term knowledge retention and on processes and outcomes of care.

Keywords: acute respiratory distress syndrome; acute respiratory infection; education; influenza; low- and middle-income countries; sepsis.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Critical Care / methods*
Critical Illness / therapy*
Developing Countries
Disease Management*
Education, Medical / methods*
Health Knowledge, Attitudes, Practice
Humans
Intensive Care Units
Professional Competence / statistics & numerical data*
Respiratory Distress Syndrome / diagnosis
Respiratory Distress Syndrome / therapy
Respiratory Tract Infections / complications
Respiratory Tract Infections / diagnosis*
Respiratory Tract Infections / therapy*
Sepsis / diagnosis
Sepsis / therapy

Abstract

Publication types

MeSH terms

Grants and funding