Journal Article

COVID-19 advanced respiratory care educational training programme for healthcare workers in Lesotho: an observational study

Hansoti, Bhakti, Osula, Valerie O, Mapota-Masoabi, Lucy, Chakare, Tafadzwa, Ranyali-Otubanjo, Makhoase, Sanders, Jill E, McCollum, Eric D

2022

Overview

ObjectiveTo develop and implement a ‘low-dose, high-frequency’ (LDHF) advanced respiratory care training programme for COVID-19 care in Lesotho.DesignProspective pretraining–post-training evaluation.SettingLesotho has limited capacity in advanced respiratory care.ParticipantsPhysicians and nurses.InterventionsDue 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 measuresParticipants 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.ResultsPretraining 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).ConclusionsAn 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.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Anatomy & physiology / Case management / Coronaviruses / COVID-19 / COVID-19 - epidemiology / Global Health / Health Personnel - education / Hospitals / Humans / Intensive care / Lesotho / MEDICAL EDUCATION & TRAINING / Medical personnel / Multiple choice / Nurses / Observational studies / Oxygen / Pandemics / Participation / Patients / Physicians / Physiology / Prospective Studies / Public health / Respiratory infections / Severe acute respiratory syndrome coronavirus 2 / Tuberculosis / Ventilators / Workers