Evidence map›Paper›PMID 37498872›Full record

ArticlePloS one2023

Organisation, staffing and resources of critical care units in Kenya.

Wambui Mwangi, Ronnie Kaddu, Carolyne Njoki Muiru, Nabukwangwa Simiyu, Vishal Patel, Demet Sulemanji, Dorothy Otieno, Stephen Okelo, Idris Chikophe, Luigi Pisani and 6 more

Abstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Wambui MwangiDepartment of Anesthesia and Intensive Care, Nyeri County Referral Hospital, Nyeri, Kenya.ORCID 0000-0001-5874-0253
Ronnie KadduKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Carolyne Njoki MuiruKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Nabukwangwa SimiyuKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Vishal PatelDepartment of Anesthesia and Intensive Care, MP Shah Hospital, Nairobi, Kenya.
Demet SulemanjiKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Dorothy OtienoKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Stephen OkeloKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Idris ChikopheKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Luigi PisaniMahidol Oxford Tropical Research Unit, Bangkok, Thailand.
Dilanthi Priyadarshani Gamage DonaMahidol Oxford Tropical Research Unit, Bangkok, Thailand.
Abi BeaneMahidol Oxford Tropical Research Unit, Bangkok, Thailand.
Rashan HaniffaMahidol Oxford Tropical Research Unit, Bangkok, Thailand.
David MisangoKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Wangari Waweru-SiikaKenya Critical Care Registry, Critical Care Society of Kenya, Nairobi, Kenya.
Kenya Critical Care Registry Investigators

Funding

Medical Research Council MR/V030884/1
6 · The paper itself

Abstract

objectiveTo describe the organisation, staffing patterns and resources available in critical care units in Kenya. The secondary objective was to explore variations between units in the public and private sectors. MATERIALS AND

methodsAn online cross-sectional survey was used to collect data on organisational characteristics (model of care, type of unit, quality- related activities, use of electronic medical records and participation in the national ICU registry), staffing and available resources for monitoring, ventilation and general critical care.

resultsThe survey included 60 of 75 identified units (80% response rate), with 43% (n = 23) located in government facilities. A total of 598 critical care beds were reported with a median of 6 beds (interquartile range [IQR] 5-11) per unit, with 26% beds (n = 157) being non functional. The proportion of ICU beds to total hospital beds was 3.8% (IQR 1.9-10.4). Most of the units (80%, n = 48) were mixed/general units with an open model of care (60%, n = 36). Consultants-in-charge were mainly anesthesiologists (69%, n = 37). The nurse-to-bed ratio was predominantly 1:2 with half of the nurses formally trained in critical care. Most units (83%, n = 47) had a dedicated ventilator for each bed, however 63% (n = 39) lacked high flow nasal therapy. While basic multiparametric monitoring was ubiquitous, invasive blood pressure measurement capacity was low (3% of beds, IQR 0-81%), and capnography moderate (31% of beds, IQR 0-77%). Blood gas analysers were widely available (93%, n = 56), with 80% reported as functional. Differences between the public and private sector were narrow.

conclusionThis study shows an established critical care network in Kenya, in terms of staffing density, availability of basic monitoring and ventilation resources. The public and private sector are equally represented albeit with modest differences. Potential areas for improvement include training, use of invasive blood pressure and functionality of blood gas analysers.

Indexed as

Critical CareIntensive Care UnitsCross-Sectional StudiesHumansKenyaWorkforce

Identifiers

PMID37498872
PMCPMC10374136

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.