TY - JOUR
T1 - COVID-19 advanced respiratory care educational training programme for healthcare workers in Lesotho
T2 - An observational study
AU - Osula, Valerie O.
AU - Sanders, Jill E.
AU - Chakare, Tafadzwa
AU - Mapota-Masoabi, Lucy
AU - Ranyali-Otubanjo, Makhoase
AU - Hansoti, Bhakti
AU - McCollum, Eric D.
N1 - Funding Information:
Competing interests EDM declares other grants from The Bill & Melinda Gates Foundation, National Institutes of Health, Pfizer, The Save the Children Fund (UK) and US Centers for Disease Control; consulting fees from Aurum Institute; and unpaid committee participation with the Lifebox Foundation (UK) and WHO. The other authors declare no competing interests.
Funding Information:
Funding This report was made possible with support from the United States Agency for International Development (USAID) funded RISE programme, under the terms of the cooperative agreement 7200AA19CA00003. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the US government.
Publisher Copyright:
© 2022 Authors.
PY - 2022/4/29
Y1 - 2022/4/29
N2 - Objective To develop and implement a € low-dose, high-frequency' (LDHF) advanced respiratory care training programme for COVID-19 care in Lesotho. Design Prospective pretraining-post-training evaluation. Setting Lesotho has limited capacity in advanced respiratory care. Participants Physicians and nurses. Interventions Due to limited participation in May-September 2020, the LDHF approach was modified into a traditional 1-day offsite training in November 2020 that reviewed respiratory anatomy and physiology, clinical principles for conventional oxygen, heated high-flow nasal cannula and non-invasive ventilation management. Basic mechanical ventilation principles were introduced. Outcome measures Participants completed a 20-question multiple choice examination immediately before and after the 1-day training. Paired t-tests were used to evaluate the difference in average participant pretraining and post-training examination scores. Results Pretraining and post-training examinations were completed by 46/53 (86.7%) participants, of whom 93.4% (n=43) were nurses. The overall mean pretraining score was 44.8% (SD 12.4%). Mean scores improved by an average of 23.7 percentage points (95% CI 19.7 to 27.6, p<0.001) on the post-training examination to a mean score of 68.5% (SD 13.6%). Performance on basic and advanced respiratory categories also improved by 17.7 (95% CI 11.6 to 23.8) and 25.6 percentage points (95% CI 20.4 to 30.8) (p<0.001). Likewise, mean examination scores increased on the post-training test, compared with pretraining, for questions related to respiratory management (29.6 percentage points, 95% CI 24.1 to 35.0) and physiology (17.4 percentage points, 95% CI 12.0 to 22.8). Conclusions An LDHF training approach was not feasible during this early emergency period of the COVID-19 pandemic in Lesotho. Despite clear knowledge gains, the modest post-training examination scores coupled with limited physician engagement suggest healthcare workers require alternative educational strategies before higher advanced care like mechanical ventilation is implementable. Conventional and high-flow oxygen is better aligned with post-training healthcare worker knowledge levels and rapid implementation.
AB - Objective To develop and implement a € low-dose, high-frequency' (LDHF) advanced respiratory care training programme for COVID-19 care in Lesotho. Design Prospective pretraining-post-training evaluation. Setting Lesotho has limited capacity in advanced respiratory care. Participants Physicians and nurses. Interventions Due to limited participation in May-September 2020, the LDHF approach was modified into a traditional 1-day offsite training in November 2020 that reviewed respiratory anatomy and physiology, clinical principles for conventional oxygen, heated high-flow nasal cannula and non-invasive ventilation management. Basic mechanical ventilation principles were introduced. Outcome measures Participants completed a 20-question multiple choice examination immediately before and after the 1-day training. Paired t-tests were used to evaluate the difference in average participant pretraining and post-training examination scores. Results Pretraining and post-training examinations were completed by 46/53 (86.7%) participants, of whom 93.4% (n=43) were nurses. The overall mean pretraining score was 44.8% (SD 12.4%). Mean scores improved by an average of 23.7 percentage points (95% CI 19.7 to 27.6, p<0.001) on the post-training examination to a mean score of 68.5% (SD 13.6%). Performance on basic and advanced respiratory categories also improved by 17.7 (95% CI 11.6 to 23.8) and 25.6 percentage points (95% CI 20.4 to 30.8) (p<0.001). Likewise, mean examination scores increased on the post-training test, compared with pretraining, for questions related to respiratory management (29.6 percentage points, 95% CI 24.1 to 35.0) and physiology (17.4 percentage points, 95% CI 12.0 to 22.8). Conclusions An LDHF training approach was not feasible during this early emergency period of the COVID-19 pandemic in Lesotho. Despite clear knowledge gains, the modest post-training examination scores coupled with limited physician engagement suggest healthcare workers require alternative educational strategies before higher advanced care like mechanical ventilation is implementable. Conventional and high-flow oxygen is better aligned with post-training healthcare worker knowledge levels and rapid implementation.
KW - COVID-19
KW - MEDICAL EDUCATION & TRAINING
KW - Public health
KW - Respiratory infections
UR - http://www.scopus.com/inward/record.url?scp=85129170718&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85129170718&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-058643
DO - 10.1136/bmjopen-2021-058643
M3 - Article
C2 - 35487754
AN - SCOPUS:85129170718
SN - 2044-6055
VL - 12
JO - BMJ open
JF - BMJ open
IS - 4
M1 - e058643
ER -