Nurses responding to the World Health Organization (WHO) priority for emergency care systems for universal health coverage (original) (raw)
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Aligning emergency care with global health priorities
International Journal of Emergency Medicine, 2018
Background: The availability of resources, knowledge, and will to expand access to high-quality emergency care in low-and middle-income countries has made strong progress in recent years. While the possibility for intervention has improved, the need has only grown more pressing. What remains is for us, the people who practice and support emergency care delivery on a regular basis, to pull these elements together and present a cohesive call to action for leaders to prioritize the development of emergency care. This advocacy should coalesce around two high-level commitments: the Sustainable Development Goals and Universal Health Coverage. Emergency care has not been a traditional tool that policy makers rely on to improve health and development; however, we can show that it is actually critical to achieving these goals. Making this case has become possible with the availability of evidence that shows emergency health conditions contribute to a substantial portion of the disease burden, emergency care interventions are high-impact, and the interventions can be implemented without a substantial increase in resources. Main body: There is a growing understanding of the burden of disease in low-and middle-income countries and how 54% or 24.3 million deaths are amenable to emergency care systems. There are a group of diseases that are time sensitive and show improved outcomes with good emergency care systems. Alongside an improving scientific underpinning to emergency care, there is growing policy recognition. While there is no direct mention of emergency care in the Sustainable Development Goals document, many goals, such as reductions in infant and maternal deaths, deaths due to non-communicable diseases, road traffic injuries and violence, improving resilience of climate change, universal coverage, and safe/sustainable urban environments are not achievable without developing, sustaining, and improving the quality of emergency care systems. Conclusion: To take emergency care to the next level, we must capitalize on the growing understanding of the disease burden of emergent conditions, along with the increasing evidence of the high-impact and low-cost of emergency care interventions. Linking these messages to widely accepted policy priorities like the SDGs and UHC will increase attention towards the development of emergency care systems, which potentially could save lives.
Annals of Emergency Medicine, 2012
The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in reducing the increasing burden of disease from acute illness and injury in populations across the socioeconomic spectrum and calls on governments and the World Health Organization to take specific and concrete actions to make this happen. This resolution constitutes recognition by the World Health Assembly of the growing public health role of emergency care systems and is the highest level of international attention ever devoted to emergency care systems worldwide. Emergency care systems for secondary prevention of acute illnesses and injury remain inadequately developed in many low-and middle-income countries, despite evidence that basic strategies for improving emergency care systems can reduce preventable mortality and morbidity and can in many cases also be cost-effective. Emergency care providers and their professional organizations have used their comprehensive expertise to strengthen emergency care systems worldwide through the development of tools for emergency medicine education, systems assessment, quality improvement, and evidence-based clinical practice. World Health Assembly 60.22 represents a unique opportunity for emergency care providers and other advocates for improved emergency care to engage with national and local health care officials and policymakers, as well as with the World Health Organization, and leverage the expertise within the international emergency medicine community to make substantial improvements in emergency care delivery in places where it is most needed.
Placing Emergency Care on the Global Agenda
Annals of Emergency Medicine, 2010
Emergency care serves a key function within health care systems by providing an entry point to health care and by decreasing morbidity and mortality. Although primarily focused on evaluation and treatment for acute conditions, emergency care also serves as an important locus of provision for preventive care with regard to injuries and disease progression. Despite its important and increasing role, however, emergency care has been frequently overlooked in the discussion of health systems and delivery platforms, particularly in developing countries. Little research has been done in lower-and middle-income countries on the burden of disease reduction attributable to emergency care, whether through injury treatment and prevention, urgent and emergency treatment of acute conditions, or emergency treatment of complications from chronic conditions. There is a critical need for research documenting the role of emergency care services in reducing the global burden of disease. In addition to applying existing methodologies toward this aim, new methodologies should be developed to determine the costeffectiveness of these interventions and how to effectively cover the costs of and demands for emergency care needs. These analyses could be used to emphasize the public health and clinical importance of emergency care within health systems as policymakers determine health and budgeting priorities in resource-limited settings.
Emergency Care and Health Systems: Consensus-based Recommendations and Future Research Priorities
Academic Emergency Medicine, 2013
The theme of the 14th annual Academic Emergency Medicine consensus conference was "Global Health and Emergency Care: A Research Agenda." The goal of the conference was to create a robust and measurable research agenda for evaluating emergency health care delivery systems. The concept of health systems includes the organizations, institutions, and resources whose primary purpose is to promote, restore, and/or maintain health. This article further conceptualizes the vertical and horizontal delivery of acute and emergency care in low-resource settings by defining specific terminology for emergency care platforms and discussing how they fit into broader health systems models. This was accomplished through discussion surrounding four principal questions touching upon the interplay between health systems and acute and emergency care. This research agenda is intended to assist countries that are in the early stages of integrating emergency services into their health systems and are looking for guidance to maximize their development and health systems planning efforts. A chieving the highest attainable standard of health requires universal access to essential services that are rationally distributed and utilized. Timely action in response to emergent disease presentations is one such essential health service. At present, many national health systems are oriented to specific diseases rather than cross-cutting "systems" interventions that might have a larger long-term effect by strengthening systemwide capacity. The natural history and epidemiology of emergencies emphasize that highly functional health systems, including intact and codified referral networks, are necessary to improve survival of patients with acute diseases. Failure to prioritize integration across disease-oriented programs and service delivery units, and failure to deliver emergency health services promptly, results in care that is poorly
African Journal of Emergency Medicine, 2020
The quality of care received by patients during the first few hours following an accident and/or acute life-threatening conditions can significantly affect the overall outcome of treatment. This study, therefore, assessed the quality of emergency nursing care in two tertiary healthcare settings in a developing Sub-Saharan African Country. Methods: The study was conducted in two renowned tertiary hospitals in Southwest Nigeria. Four hundred and twenty-eight patients selected by purposive sampling technique from the two hospitals formed the sample. The Donabedian three-pronged approach of structure, process and outcome domains was employed for data collection. Two instruments; an adapted validated structured questionnaire and an observation checklist were used for data collection and data collected were analysed with the aid of Statistical Package for Social Sciences (SPSS 24) using mainly descriptive statistics such as frequency counts and percentages. Results: Results showed that a majority (62.6%) rated the quality of emergency nursing care as high though observation revealed glaring differences in the structure, process and outcome domains of quality in selected hospitals. Discussion/Conclusion: The study, therefore, concluded that while the quality of emergency nursing care in the selected hospitals can be described in general as average, a lot still needs to be done to address the identified deficiencies in emergency nursing care. African relevance • Revealing emergency nursing care from African perspective. • Making data available on quality of emergency nursing care in Africa. • Facilitation of best emergency nursing practice in Africa. • Providing knowledge that reduces mortality rate in Africa. Recently, the Centres for Medicaid Services declared that emergency departments are critical to handling 28% of all acute visits in the United States [8]. The proportion of individuals requiring emergency care in the low and middle-income African countries would probably
Revista Latino-Americana de Enfermagem, 2017
Objective: to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs) towards the achievement of Universal Health Converge (UHC) as perceived by health key informants in Jordan. Methods: an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. Results: the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. Conclusion: study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and...
Disaster Nursing and Emergency Preparedness, 2018
A highly successful editor and a prolific author, Dr. Veenema has published textbooks, handbooks, decision support software, and over 90 articles on emergency nursing and disaster preparedness. She has taught public health preparedness for over 25 years and has authored four highly successful national e-learning courses in disaster and public health preparedness for healthcare providers (Coursera, Elsevier, MC Strategies, American Red Cross). These interactive, e-learning programs have trained thousands of nurses and other disaster health services responders in caring for victims of disasters, terrorist events, and public health emergencies. A motivated, energetic, and self-directed leader with an impressive degree of creativity and innovation, Dr. Veenema is in high demand as a speaker and her information technology applications for disaster response have been presented at conferences around the globe. Dr. Veenema is the developer of Disaster Nursing, an innovative technology application ("App") for the smartphone and tablet (Unbound Medicine). Dr. Veenema received her Bachelor of Science degree in Nursing from Columbia University in 1980, a Master of Science in Nursing Administration (1992), post-master's degree in the Care of Children and Families (1993) from the
Strengthening Health Systems to Provide Emergency Care
All around the world, acutely ill and injured people of all ages seek care every day. They will call neighbors, the police, or universal emergency numbers for help. They will be assisted by family members, community members with first-aid training, or professional prehospital providers. They may travel to a health care facility by foot, motorcycle, taxi, or ambulance. On arrival, they may or may not find a designated emergency area and providers capable of delivering the care they need. Emergency care systems (ECSs) address a wide range of acute conditions, including injuries, communicable and noncommunicable diseases, and complications of pregnancy. Especially when there are barriers to health care access, people may seek care only when acutely ill or injured. Emergency care is an essential component of universal health coverage—a critical mechanism for ensuring accessible, affordable, high-quality care—and for many people around the world, it is the primary point of access to the health system. The World Health Organization (WHO) has defined a series of essential functions for an ECS that span from prehospital care and transport through facility-based emergency unit care to early operative and critical care (figure 13.1). Each of these functions can be achieved in many ways, depending on available resources, and each is essential to the delivery of effective emergency care. Each of the previous eight volumes of this edition of Disease Control Priorities (third edition) (DCP3) presents a package of essential services and highlights urgent services for conditions likely to result in morbidity or mortality if not addressed rapidly. An ECS is an integrated mechanism to address these time-sensitive conditions, and this chapter integrates the urgent interventions from all the Disease Control Priorities packages with the WHO ECS framework to derive a package of essential emergency care services, including key policy strategies for system development. This effort is intended to identify ways in which national health care systems globally can be strengthened to provide emergency care more effectively.