PDF(Pubmed)
Abstract：
UNASSIGNED: The Disease Control Priorities Project estimates that over 50 % of annual mortality in low- and middle-income countries can be addressed by improved emergency care. Sierra Leone\'s Ministry of Health and Sanitation has highlighted emergency care as a national priority. We conducted the first multicentre analysis of emergency care capacity in Sierra Leone, using the Hospital Emergency Unit Assessment Tool (HEAT) to analyse 14 government hospitals across the country.
UNASSIGNED: HEAT is a standardised assessment that is recommended in the World Health Organisation Emergency Care Toolkit. It has been used comparably elsewhere. To analyse Sierra Leone\'s emergency care capacity with the HEAT data, we created the HEAT-adjusted Emergency Care Capacity Score. Purposeful sampling was used to select 14 government facilities nationwide. A multidisciplinary team was interviewed over a 2-day in-person visit to each facility.
UNASSIGNED: Human Resources was the strongest parameter, scoring 49 %. All hospitals provided emergency cover 24/7. Emergency Diagnostic Services was the most severely limited parameter, scoring 29 %. 3 hospitals had no access to basic radiography. Infrastructure scored 47 %. 2 hospitals had adequate electricity supply; 5 had adequate clean, running water. No hospitals had adequate oxygen supply. Clinical services scored 39 %. 10 hospitals had no designated Emergency Unit, only 2 triaged to stratify severity. Signal functions scored 38 %. No hospitals had reliable access to emergency drugs such as adrenaline. The total HEAT-adjusted Emergency Care Capacity Score across all hospitals was 40 %.
UNASSIGNED: These data identify gaps that have already led to local interventions, including focussing emergency resources to a resuscitation area, and training multidisciplinary teams in emergency care skills. This facility-level analysis could feed into wider assessment of Sierra Leone\'s emergency care systems at every level, which may help prioritise government strategy to target sustainable strengthening of national emergency care.
UNASSIGNED: HEAT is a standardised assessment that is recommended in the World Health Organisation Emergency Care Toolkit. It has been used comparably elsewhere. To analyse Sierra Leone\'s emergency care capacity with the HEAT data, we created the HEAT-adjusted Emergency Care Capacity Score. Purposeful sampling was used to select 14 government facilities nationwide. A multidisciplinary team was interviewed over a 2-day in-person visit to each facility.
UNASSIGNED: Human Resources was the strongest parameter, scoring 49 %. All hospitals provided emergency cover 24/7. Emergency Diagnostic Services was the most severely limited parameter, scoring 29 %. 3 hospitals had no access to basic radiography. Infrastructure scored 47 %. 2 hospitals had adequate electricity supply; 5 had adequate clean, running water. No hospitals had adequate oxygen supply. Clinical services scored 39 %. 10 hospitals had no designated Emergency Unit, only 2 triaged to stratify severity. Signal functions scored 38 %. No hospitals had reliable access to emergency drugs such as adrenaline. The total HEAT-adjusted Emergency Care Capacity Score across all hospitals was 40 %.
UNASSIGNED: These data identify gaps that have already led to local interventions, including focussing emergency resources to a resuscitation area, and training multidisciplinary teams in emergency care skills. This facility-level analysis could feed into wider assessment of Sierra Leone\'s emergency care systems at every level, which may help prioritise government strategy to target sustainable strengthening of national emergency care.
摘要：
疾病控制优先项目估计，低收入和中等收入国家超过50%的年死亡率可以通过改善急诊护理来解决。塞拉利昂卫生和卫生部强调紧急护理是国家优先事项。我们对塞拉利昂的急诊护理能力进行了首次多中心分析，使用医院急诊室评估工具(HEAT)分析全国14家政府医院。
HEAT是世界卫生组织紧急护理工具包中推荐的标准化评估。它在其他地方被比较使用。用HEAT数据分析塞拉利昂的紧急护理能力，我们创建了HEAT调整后的急诊护理能力评分.在全国范围内采用有目的的抽样方法选择了14个政府机构。通过对每个设施进行为期2天的亲自访问，采访了一个多学科小组。
■人力资源是最强的参数，得分49%。所有医院都提供24/7紧急保险。紧急诊断服务是最严格限制的参数，得分29%。3家医院无法获得基本的放射线照相术。基础设施得分47%。2家医院有足够的电力供应；5家医院有足够的清洁，流水。没有医院有足够的氧气供应。临床服务得分39%。10家医院没有指定的急诊室，只有2个分类以分层严重程度。信号功能得分38%。没有医院能够可靠地获得肾上腺素等紧急药物。所有医院的HEAT调整后的紧急护理能力总得分为40％。
■这些数据确定了已经导致地方干预的差距，包括将应急资源集中到复苏区域，并培训多学科团队的紧急护理技能。这种设施级别的分析可以纳入对塞拉利昂各级紧急护理系统的更广泛评估，这可能有助于优先考虑政府战略，以可持续地加强国家紧急护理。
HEAT是世界卫生组织紧急护理工具包中推荐的标准化评估。它在其他地方被比较使用。用HEAT数据分析塞拉利昂的紧急护理能力，我们创建了HEAT调整后的急诊护理能力评分.在全国范围内采用有目的的抽样方法选择了14个政府机构。通过对每个设施进行为期2天的亲自访问，采访了一个多学科小组。
■人力资源是最强的参数，得分49%。所有医院都提供24/7紧急保险。紧急诊断服务是最严格限制的参数，得分29%。3家医院无法获得基本的放射线照相术。基础设施得分47%。2家医院有足够的电力供应；5家医院有足够的清洁，流水。没有医院有足够的氧气供应。临床服务得分39%。10家医院没有指定的急诊室，只有2个分类以分层严重程度。信号功能得分38%。没有医院能够可靠地获得肾上腺素等紧急药物。所有医院的HEAT调整后的紧急护理能力总得分为40％。
■这些数据确定了已经导致地方干预的差距，包括将应急资源集中到复苏区域，并培训多学科团队的紧急护理技能。这种设施级别的分析可以纳入对塞拉利昂各级紧急护理系统的更广泛评估，这可能有助于优先考虑政府战略，以可持续地加强国家紧急护理。
