Consensus statements for the establishment of medical intensive care in low-resource settings: international study using modified Delphi methodology.

IF 8.8 1区 医学 Q1 CRITICAL CARE MEDICINE
Pedja Kovacevic, Jadranka Vidovic, Boris Tomic, Jihad Mallat, Ali Ait Hssain, Muyiwa Rotimi, Owoniya Temitope Akindele, Kent Doi, Rajesh Mishra, F Joachim Meyer, Ivan Palibrk, Ranko Skrbic, Enrique Boloña, Oguz Kilickaya, Ognjen Gajic
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引用次数: 0

Abstract

Background: The inadequacy of intensive care medicine in low-resource settings (LRS) has become significantly more visible after the COVID-19 pandemic. Recommendations for establishing medical critical care are scarce and rarely include expert clinicians from LRS.

Methods: In December 2023, the National Association of Intensivists from Bosnia and Herzegovina organized a hybrid international conference on the topic of organizational structure of medical critical care in LRS. The conference proceedings and literature review informed expert statements across several domains. Following the conference, the statements were distributed via an online survey to conference participants and their wider professional network using a modified Delphi methodology. An agreement of ≥ 80% was required to reach a consensus on a statement.

Results: Out of the 48 invited clinicians, 43 agreed to participate. The study participants came from 20 countries and included clinician representatives from different base specialties and health authorities. After the two rounds, consensus was reached for 13 out of 16 statements across 3 domains: organizational structure, staffing, and education. The participants favored multispecialty medical intensive care units run by a medical team with formal intensive care training. Recognition and support by health care authorities was deemed critical and the panel underscored the important roles of professional organizations, clinician educators trained in high-income countries, and novel technologies such as tele-medicine and tele-education.

Conclusion: Delphi process identified a set of consensus-based statements on how to create a sustainable patient-centered medical intensive care in LRS.

在低资源环境中建立医疗重症监护的共识声明:使用改良德尔菲方法进行的国际研究。
背景:在 COVID-19 大流行之后,低资源环境(LRS)重症医学的不足变得更加明显。建立重症医学护理的建议很少,而且很少包括来自低资源环境的临床专家:方法:2023 年 12 月,波斯尼亚和黑塞哥维那全国重症医学专家协会组织了一次混合国际会议,主题是 LRS 重症医学护理的组织结构。会议记录和文献综述为多个领域的专家声明提供了依据。会后,采用改良的德尔菲方法,通过在线调查向与会者及其更广泛的专业网络分发了声明。结果:结果:在受邀的 48 名临床医生中,43 人同意参与。研究参与者来自 20 个国家,包括来自不同基础专科和卫生部门的临床医生代表。经过两轮讨论,在组织结构、人员配备和教育 3 个领域的 16 项声明中,有 13 项达成了共识。与会者倾向于由受过正规重症监护培训的医疗团队管理的多专科医疗重症监护病房。医疗机构的认可和支持被认为至关重要,小组强调了专业组织、在高收入国家接受过培训的临床教育工作者以及远程医疗和远程教育等新技术的重要作用:德尔菲进程确定了一套基于共识的声明,内容涉及如何在长者健康服务中创建以患者为中心的可持续医疗重症监护。
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来源期刊
Critical Care
Critical Care 医学-危重病医学
CiteScore
20.60
自引率
3.30%
发文量
348
审稿时长
1.5 months
期刊介绍: Critical Care is an esteemed international medical journal that undergoes a rigorous peer-review process to maintain its high quality standards. Its primary objective is to enhance the healthcare services offered to critically ill patients. To achieve this, the journal focuses on gathering, exchanging, disseminating, and endorsing evidence-based information that is highly relevant to intensivists. By doing so, Critical Care seeks to provide a thorough and inclusive examination of the intensive care field.
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