Improving pain management for trauma patients at two Rwandan emergency departments.

Background: Little is known regarding the effectiveness of pain protocols and guideline use in Emergency Departments (ED) in Sub-Saharan Africa. Therefore, to shed light on this research gap, this study had the following objectives: 1) to evaluate if the implementation of the Essential Pain Management (EPM) course combined with mentorship to use the World Health Organization (WHO) pain ladder-based protocol improves the quality of pain management among trauma patients at the ED of two teaching hospitals in Rwanda; and 2) to determine barriers to implementing the WHO pain ladder-based protocol among trauma patients in the same settings.

Methods: This was a pre- and post-intervention study.

Core sepsis-related competencies for medical students: an international consensus by Delphi technique.

Background: Sepsis is a life-threatening condition which may arise from infection in any organ system and requires early recognition and management. Healthcare professionals working in any specialty may need to manage patients with sepsis. Educating medical students about this condition may be an effective way to ensure all future doctors have sufficient ability to diagnose and treat septic patients.

Global critical care: a call to action.

Critical care is underprioritized. A global call to action is needed to increase equitable access to care and the quality of care provided to critically ill patients. Current challenges to effective critical care in resource-constrained settings are many.

Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations.

Background: Surgical capacity building has gained substantial momentum. However, care at the hospital level depends on improved access to emergency services. There is no established model for facilitating trauma and EMS system capacity in LMIC settings.

A qualitative evaluation of an operational research course for acute care trainees in Kigali, Rwanda.

Introduction: the blended SORT-IT model uses a combination of online modules and teleconferences with local and international mentors to teach operational research. We modified SORT-IT to create the Acute Care Operational Research (ACOR) course directed to anesthesiology residents in Kigali, Rwanda. This course takes students from an initial research idea through submitting a paper for publication.

Sepsis in two hospitals in Rwanda: A retrospective cohort study of presentation, management, outcomes, and predictors of mortality.

Purpose: Few studies have assessed the presentation, management, and outcomes of sepsis in low-income countries (LICs). We sought to characterize these aspects of sepsis and to assess mortality predictors in sepsis in two referral hospitals in Rwanda.

Materials And Methods: This was a retrospective cohort study in two public academic referral hospitals in Rwanda.

Improving hand hygiene measures in low-resourced intensive care units: experience at the Kigali University Teaching Hospital in Rwanda.

Background: Proper hand hygiene (HH) practices have been shown to reduce healthcare-acquired infections. Several potential challenges in low-income countries might limit the feasibility of effective HH, including preexisting knowledge gaps and staffing.

Aim: We sought to evaluate the feasibility of the implementation of effective HH practice at a teaching hospital in Rwanda.

Developing and implementing a novel mentorship model (4) for maternal, newborn and child health in Rwanda.

Background: There are a number of factors that may contribute to high mortality and morbidity of women and newborns in low-income countries. These include a shortage of competent health care providers (HCP) and a lack of sufficient continuous professional development (CPD) opportunities. Strengthening the skills and building the capacity of HCP involved in the provision of maternal, newborn and child health (MNCH) is essential to ensure quality care for mothers, newborns and children.

Using the World Society of Emergency Surgery (WSES) Triage Tool to Evaluate Timing of Emergency Surgery in Rwanda.

Background: Access to timely and safe emergency general surgery remains a challenge in sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study has the following objectives: (1) to compare the actual time to surgery (aTTS) to the ideal time to surgery among patients undergoing emergency surgery and (2) to explore the use of home to emergency department time (HET) as a new measurement indicator for time from symptoms onset to admission at ED at a referral hospital.

Methods: We performed a retrospective review of emergency general surgery cases performed at the Centre Hospitalier Universitaire de Kigali in Rwanda between June 1 and November 31, 2016.

Anesthesia Provider Training and Practice Models: A Survey of Africa.

Background: In Africa, most countries have fewer than 1 physician anesthesiologist (PA) per 100,000 population. Nonphysician anesthesia providers (NPAPs) play a large role in the workforce of many low- and middle-income countries (LMICs), but little information has been systematically collected to describe existing human resources for anesthesia care models. An understanding of existing PA and NPAP training pathways and roles is needed to inform anesthesia workforce planning, especially for critically underresourced countries.

Implementing the World Health Organization safe childbirth checklist in a district Hospital in Rwanda: a pre- and post-intervention study.

Background: Worldwide maternal mortality remains high, with approximately 830 maternal deaths occurring each day. About 90% of these deaths occur in low-income countries. Evidenced-based essential birth practices administered during routine obstetrical care and childbirth are key to reducing maternal and neonatal deaths.

Improving Surgical Safety and Nontechnical Skills in Variable-Resource Contexts: A Novel Educational Curriculum.

Objective: A substantial proportion of adverse intraoperative events are attributed to failures in nontechnical skills. To strengthen these skills and improve surgical safety, the Non-Technical Skills for Surgeons (NOTSS) taxonomy was developed as a common framework. The NOTSS taxonomy was adapted for low- and middle-income countries, where variable resources pose a significant challenge to safe surgery.

Longer travel time to district hospital worsens neonatal outcomes: a retrospective cross-sectional study of the effect of delays in receiving emergency cesarean section in Rwanda.

Background: In low-resource settings, access to emergency cesarean section is associated with various delays leading to poor neonatal outcomes. In this study, we described the delays a mother faces when needing emergency cesarean delivery and assessed the effect of these delays on neonatal outcomes in Rwanda.

Methods: This retrospective study included 441 neonates and their mothers who underwent emergency cesarean section in 2015 at three district hospitals in Rwanda.

A geospatial evaluation of timely access to surgical care in seven countries.

Objective: To assess the consistent availability of basic surgical resources at selected facilities in seven countries.

Methods: In 2010-2014, we used a situational analysis tool to collect data at district and regional hospitals in Bangladesh ( = 14), the Plurinational State of Bolivia ( = 18), Ethiopia ( = 19), Guatemala ( = 20), the Lao People's Democratic Republic ( = 12), Liberia ( = 12) and Rwanda ( = 25). Hospital sites were selected by pragmatic sampling.