Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]

Background This study aimed to assess the current status of critical care services in 13 districts of Bagmati Province in Nepal, with a focus on access, infrastructure, human resources, and intensive care unit (ICU) services. Methods A cross-sectional survey was conducted among healthcare workers em...

Full description

Saved in:
Bibliographic Details
Main Authors: Subekshya Luitel, Sushila Paudel, Diptesh Aryal, Janaki Pandey, Hem Raj Paneru, Roshni Shakya, Prashant Acharya, Isha Amatya, Rashan Haniffa, Suman Pant, Abi Beane, Pradip Gyanwali
Format: Article
Language:English
Published: Wellcome 2024-12-01
Series:Wellcome Open Research
Subjects:
Online Access:https://wellcomeopenresearch.org/articles/8-575/v3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850242998166618112
author Subekshya Luitel
Sushila Paudel
Diptesh Aryal
Janaki Pandey
Hem Raj Paneru
Roshni Shakya
Prashant Acharya
Isha Amatya
Rashan Haniffa
Suman Pant
Abi Beane
Pradip Gyanwali
author_facet Subekshya Luitel
Sushila Paudel
Diptesh Aryal
Janaki Pandey
Hem Raj Paneru
Roshni Shakya
Prashant Acharya
Isha Amatya
Rashan Haniffa
Suman Pant
Abi Beane
Pradip Gyanwali
author_sort Subekshya Luitel
collection DOAJ
description Background This study aimed to assess the current status of critical care services in 13 districts of Bagmati Province in Nepal, with a focus on access, infrastructure, human resources, and intensive care unit (ICU) services. Methods A cross-sectional survey was conducted among healthcare workers employed in 87 hospitals having medical/surgical ICUs across Bagmati Province. Data were collected through structured questionnaires administered via face-to-face and telephone interviews. Descriptive analysis was used for data analysis, involving frequencies and percentages. Results From 87 hospitals, a total of 123 ICUs were identified in the province, providing 1167 beds and 615 functioning ventilators. The average ICU bed availability per 100,000 population was 19, ranging from 3.6 in Makwanpur to 33.9 in Kathmandu. Out of 13 districts, 95% of beds were concentrated in just four districts, while six had no ICU facilities. Of the available facilities, 69.9% were owned by private entities. One-to-one nurse-to-ventilated bed ratio was maintained by 63.4% of ICUs during daytime, and 62.6% at nighttime. Furthermore, 74.8% of ICUs had consultants trained in critical care medicine. While essential equipment availability was higher in Bagmati province, gaps existed in the availability of oxygen plants and isolation rooms. Similarly, many ICUs offered continuous medical education and cardiopulmonary resuscitation (CPR) training, but improvements were necessary in clinical audits, antibiotic stewardship programs, and research engagement. Conclusions Disparities in critical care resources were evident across districts in Bagmati Province, highlighting the need for a balanced and decentralized approach to ensure equitable access to care. Although there were disparities, numerous ICUs were effectively carrying out multiple critical care procedures. This study suggests conducting a nationwide mapping of ICU resources, prioritizing infrastructure development, optimizing resource allocation, and establishing national protocols.
format Article
id doaj-art-62fbfea46e224803a6037df4a3b67f86
institution OA Journals
issn 2398-502X
language English
publishDate 2024-12-01
publisher Wellcome
record_format Article
series Wellcome Open Research
spelling doaj-art-62fbfea46e224803a6037df4a3b67f862025-08-20T02:00:08ZengWellcomeWellcome Open Research2398-502X2024-12-01810.12688/wellcomeopenres.19932.325778Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]Subekshya Luitel0https://orcid.org/0009-0005-0423-8926Sushila Paudel1https://orcid.org/0000-0002-4824-8625Diptesh Aryal2Janaki Pandey3Hem Raj Paneru4https://orcid.org/0000-0002-3487-5388Roshni Shakya5Prashant Acharya6Isha Amatya7https://orcid.org/0000-0001-6778-8275Rashan Haniffa8Suman Pant9https://orcid.org/0000-0001-6135-7095Abi Beane10https://orcid.org/0000-0001-7046-1580Pradip Gyanwali11Nepal Intensive Care Research Foundation, Kathmandu, Bagmati Province, NepalNepal Intensive Care Research Foundation, Kathmandu, Bagmati Province, NepalNepal Intensive Care Research Foundation, Kathmandu, Bagmati Province, NepalNepal Health Research Council, Kathmandu, Bagmati Province, NepalNepal Intensive Care Research Foundation, Kathmandu, Bagmati Province, NepalNepal Intensive Care Research Foundation, Kathmandu, Bagmati Province, NepalNepal Intensive Care Research Foundation, Kathmandu, Bagmati Province, NepalNepal Intensive Care Research Foundation, Kathmandu, Bagmati Province, NepalMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandNepal Health Research Council, Kathmandu, Bagmati Province, NepalMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandNepal Health Research Council, Kathmandu, Bagmati Province, NepalBackground This study aimed to assess the current status of critical care services in 13 districts of Bagmati Province in Nepal, with a focus on access, infrastructure, human resources, and intensive care unit (ICU) services. Methods A cross-sectional survey was conducted among healthcare workers employed in 87 hospitals having medical/surgical ICUs across Bagmati Province. Data were collected through structured questionnaires administered via face-to-face and telephone interviews. Descriptive analysis was used for data analysis, involving frequencies and percentages. Results From 87 hospitals, a total of 123 ICUs were identified in the province, providing 1167 beds and 615 functioning ventilators. The average ICU bed availability per 100,000 population was 19, ranging from 3.6 in Makwanpur to 33.9 in Kathmandu. Out of 13 districts, 95% of beds were concentrated in just four districts, while six had no ICU facilities. Of the available facilities, 69.9% were owned by private entities. One-to-one nurse-to-ventilated bed ratio was maintained by 63.4% of ICUs during daytime, and 62.6% at nighttime. Furthermore, 74.8% of ICUs had consultants trained in critical care medicine. While essential equipment availability was higher in Bagmati province, gaps existed in the availability of oxygen plants and isolation rooms. Similarly, many ICUs offered continuous medical education and cardiopulmonary resuscitation (CPR) training, but improvements were necessary in clinical audits, antibiotic stewardship programs, and research engagement. Conclusions Disparities in critical care resources were evident across districts in Bagmati Province, highlighting the need for a balanced and decentralized approach to ensure equitable access to care. Although there were disparities, numerous ICUs were effectively carrying out multiple critical care procedures. This study suggests conducting a nationwide mapping of ICU resources, prioritizing infrastructure development, optimizing resource allocation, and establishing national protocols.https://wellcomeopenresearch.org/articles/8-575/v3intensive care unit (ICU) high dependency unit critical care services critical care resources critical care structure critical care staffingeng
spellingShingle Subekshya Luitel
Sushila Paudel
Diptesh Aryal
Janaki Pandey
Hem Raj Paneru
Roshni Shakya
Prashant Acharya
Isha Amatya
Rashan Haniffa
Suman Pant
Abi Beane
Pradip Gyanwali
Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]
Wellcome Open Research
intensive care unit (ICU)
high dependency unit
critical care services
critical care resources
critical care structure
critical care staffing
eng
title Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]
title_full Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]
title_fullStr Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]
title_full_unstemmed Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]
title_short Critical care services in Bagmati province of Nepal: A cross sectional survey [version 3; peer review: 3 approved, 1 approved with reservations]
title_sort critical care services in bagmati province of nepal a cross sectional survey version 3 peer review 3 approved 1 approved with reservations
topic intensive care unit (ICU)
high dependency unit
critical care services
critical care resources
critical care structure
critical care staffing
eng
url https://wellcomeopenresearch.org/articles/8-575/v3
work_keys_str_mv AT subekshyaluitel criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT sushilapaudel criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT diptesharyal criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT janakipandey criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT hemrajpaneru criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT roshnishakya criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT prashantacharya criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT ishaamatya criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT rashanhaniffa criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT sumanpant criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT abibeane criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations
AT pradipgyanwali criticalcareservicesinbagmatiprovinceofnepalacrosssectionalsurveyversion3peerreview3approved1approvedwithreservations