improving safety in pediatric anesthesia in moldova
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Improving Safety in Pediatric Anesthesia in Moldova. Markus Schily Biel, Switzerland. Is more safety in anesthesia in Eastern Europe needed ? Who is responsible for it ? Who is going to do it ?. Moldova. 3.3 mill . people. Anesthesia safety differs in Europe. - PowerPoint PPT PresentationTRANSCRIPT
Improving Safety in Pediatric Anesthesia in Moldova
Markus SchilyBiel, Switzerland
Is more safety in anesthesia in Eastern Europeneeded?
Who is responsible for it?
Who is going to do it?
Moldova
3.3 mill. people
Anesthesia safety differs in Europe
Motivation, technologies, knowledge
Example1: Children should have anesthesia for TE
Example2: Children should have painfree CC
Example3: Most ped.anesthesia should be combined with a regional block
Intercultural learning
Different Standards:
Progress
A project to improve anesthesia safety
2007: first activities with Moldovan doctors
2008: foundation of IATC
I = Information
A = Assistance
T = Technologies
C = Communication
Driving on the left side?
KEEP LEFT!
Promote empathy, role-play .
Supports students in making the shift in perspective:
own culture becomes a strange, looked at from the outside,target culture becomes familiar.
Wikipedia:
Gradual approach:
I. Identification and understanding of the fundamental values
of the host country
II. Acquisition of the keys needed to decode new situations
III. Adaptation of behaviour
Inter Cultural Learning
Improving Safety - Projects obstacles
Funding?
Language & culture barrier
Ministry of Health: decision maker
Understanding - teaching in 2007 by IATC
Sterile surgery drapes
2012: Moldovan Anesthesia Machines
Who is going to listen to us?
German Ministry of HealthZ31 International Cooperation
Lawrence of Arabia: united the Beduin tribes…
Target governmental funding
introduction of modern drugs and technologies
Strategy:
Ministries of Health
Annual meetings in Moldova Anesthesia Safety
Anesthesia equipment upgrade
Involving societies, find a name of activities
improved anesthesia training
Strategy: Improve communication
Fundraising strategy
Private fundraising
improving means of teaching, humanitarian aid
Initial IATC project in Moldova:
Upgrade of anesthesia equipment
2007: First donated anesthesia machine
Bern 2008 – used anesthesia machines for Moldova
These machines went from Luzern to Moldova
IATC aid to Moldova included:
Budget of about 2 Mill. EUR
More than 80 anesthesia working stations
3 ultrasound machines, 55 syringe pumps
150 hospital beds
Ambulance car
All three children hospitals
fully equiped with new
anesthesia machines
Reduced pediatric anesthesia mortality compared to 2007
ref: MoH Moldova, 2012
First result
Improving communication between societies
WFSA
SARM
ESPA delegate from Moldova
2011 -2013, sponsored and supported by IATC
Commission SARM, MoH, ESA: Reform of anesthesia residency
2010 – 2011, sponsored and supported by IATC
Situation ahead of Anesthesia Reform (before 2011)
1. Pediatric Anesthesia Residency 4 years
(separate Residency)
2. Anesthesia Residency: 4 years
3. Moldovan Syllabus
4. Moldovan oral Exam
Plan of Reform , Anesthesia Residency Moldova, Nov. 2011:
1. Pediatric Anesthesia Residency integrated
2. Residency: 5 years
3. European Syllabus
4. EDAIC exam
Moldovan anesthesia exam result 2012: 100% candidates passing
EDAIC exam Chisinau exam result 2012: 0 % candidates passing
What is wrong?
Corruption
Extra fees to doctors
MC questions: known ahead of exam
Everything can be bought
2012: last 35 anesthesia machines / monitors delivered
New Teaching Concept:
Mobile
Simulation based & clinical teaching
OLA
Mobile Anesthesia Simulation Unit
Curriculum:
Recommendations, guidelines
Crisis management, crew resource management
Rare case management, patient transfer
Simulation cannot replace clinical teaching!
German GiZ funding till end of 2013
Sim baby, Sim 3G man, Sim junior
Ambulance car, transport car
Anesthesia working place
Simulation in Switzerland, 2013
Cardiac arrest afteraspiration
No ECG leads!
ESPA Safety Committee and Simulation:
Joint venture: spread guidelines and recommendations
Pediatric Anesthesia Simulation Course: ESimPA
ESimPA:
1. European network 2. Small mobile teaching teams 3. Inclusion of Eastern Europe4. Coordinating simulation activities with ESPA5. Certification of attendance (ESPA
First steps:
Moldovan project ESPA safety project
TTC for ESimPA tutors
ESimPA tutors: Simulation stage in Swiss and German hospitals
Learning from others: Visitations
Conclusion:
6 yrs.IATC project proved that anesthesia safety differs significantly in Europe
Technical upgrade must be followed by teaching activities
ESPA: key factor in making European pediatric anesthesia more safe
IATC supports ESPA…
It‘s all about anesthesia safety in Europe
2010 2011