Emergency care in developing nations: The role of emergency nurses in Galle, Sri Lanka

摘要

Background: Emergency nurses are vital in successfully treating and caring for trauma patients in developed trauma systems. However there is a paucity of literature regarding the contribution of emergency nurses to trauma care in developing countries. The Boxing Day Tsunami of 2004, along with the increasing impact of road trauma, provided the impetus to improve disaster preparedness and trauma care in southern Sri Lanka. This paper describes the impact of emergency nurses in improving emergency trauma care in Galle, Sri Lanka, at Teaching Hospital Karapitiya (THK), a major teaching hospital of 1600 beds situated in Galle, 116 km to the south of Colombo. Method: The 'Health for the South' project, which commenced in February 2007, is a 5-year program of Trauma System Development in Sri Lanka over 3 stages which aims to implement an emergency and trauma system at Teaching Hospital Karapitiya, Galle. Specific training programs as part of the first (foundation) and second (development) stage of the program were developed and delivered in partnership with THK staff, the co-located University of Ruhuna and The Alfred and Royal Children's Hospitals in Melbourne, Australia. These programs were delivered by six visiting teams, each consisting of one emergency consultant and two critical care nurses. The first team completed a three-week trauma education module in April-May 2007. Results: The primary challenges identified were related to documentation, equipment, consumables, standard and transmission based precautions, role delegation, analgesia, knowledge and skills. Nurses as part of a combined medical and nursing team were the driving force to facilitating and achieving an observed change in these areas. Conclusions: Nurses are responsible for clinical and non-clinical areas within Emergency Departments in the developed world. Emergency nurses are integral to the planning and rapid implementation of interdisciplinary emergency care programs in the developing world.