赞比亚卢萨卡的大学教学医院中麻醉学与重症监护医学的教育和研究发展：描述性观察研究
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Development of Education and Research in Anesthesia and Intensive Care Medicine at the University Teaching Hospital in Lusaka, Zambia: A Descriptive Observational Study
背景与目的
2006年的数据显示，赞比亚卢萨卡大学教学医院的麻醉常规不符合国际标准。不仅与环境、设备和毒麻药有关的资源匮乏，还严重缺乏医师，也没有培训麻醉医师的资格和能力。也没有发展专业水平的研究基础。本研究旨在评估患者治疗情况、教育水平和调查研究，以明确十年之后病情的变化情况。
方 法
收集了质量和数量的数据，以便了解赞比亚卢萨卡大学教学医院目前的麻醉状况。对2006至2015年在医院工作的工作人员有目的的抽样，进行半结构化访谈。通过回顾研究期间的相关部门和医院记录，收集了医疗环境的详细资料。使用2006年研究中描述的方法对所有数据进行主题分析，该方法描述了与医院麻醉实践相关的患者治疗情况、教育水平和调查研究。
结 果
麻醉实践的大部分已经有了积极的发展，最显著的是对麻醉医师开展了研究生培训计划。这使佐治亚州的麻醉工作人员在4年内增加了6倍，作为计划的其中一部分，开创了一个积极的研究方向。改善了药物监管和使用标准，麻醉工作已经从手术室扩大到医院其他地方。脊髓麻醉下剖腹产手术数量的大幅度增加可能是更安全的实施麻醉的标志。但麻醉医师还未实施疼痛管理。
结 论
建立国际伙伴关系以支持赞比亚麻醉医师的研究生培训计划，使麻醉医师的数量显着增加，并进一步发展了麻醉工作的几乎所有方面。通过全球卫生合作伙伴关系促进了培训计划，为该项目提供了高水平的支持，为北南和国际学习提供了机会。
原始文献摘要
Janowicz, A., et al., Development of Education and Research in Anesthesia and Intensive Care Medicine at the University Teaching Hospital in Lusaka, Zambia: A Descriptive Observational Study. Anesthesia and analgesia, 2017. 125(1): p. 287-293.
BACKGROUND:
Data from 2006 show that the practice of anesthesia at the University Teaching Hospital in Lusaka, Zambia was underdeveloped by international standards. Not only was there inadequate provision of resources related to environment, equipment, and drugs, but also a severe shortage of staff, with no local capability to train future physician anesthetic providers. There was also noresearch base on which to develop the specialty. This study aimed to evaluate patient care, education and research to determine whether conditions had changed a decade later.
METHODS:
A mix of qualitative data and quantitative data was gathered to inform the current state of anesthesia at the UniversityTeaching Hospital, Lusaka, Zambia. Semistructured interviews were conducted with key staff identified by purposive sampling, including staff who had worked at the hospital throughout 2006 to 2015. Further data detailing conditions in the environment were collected by reviewing relevant departmental and hospital records spanning the study period. All data were analyzed thematically, using the framework described in the 2006 study, which described patient care, education, and research related to anesthetic practice at the hospital.
RESULTS:
There have been positive developments in most areas of anesthetic practice, with the most striking being implementation of a postgraduate training program for physician anesthesiologists. This has increased physician anesthesia staff in Zambia 6-fold within 4 years, and created an active research stream as part of the program. Standards of monitoring and availability of drugs have improved, and anesthetic activity has expanded out of operating theaters into the rest of the hospital. A considerable increase in the number of cesarean deliveries performed under spinal anesthetic may be a marker for safer anesthetic practice. Anesthesiologists have yet to take responsibility for the management of pain.
CONCLUSIONS:
The establishment of international partnerships to support postgraduate training of physician anesthetists in Zambiahas created a significant increase in the number of anesthesia providers and has further developed nearly all aspects of anesthetic practice. The facilitation of the training program by a global health partnership has leveraged high-level support for the project and provided opportunities for North-South and international learning.
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