TIMELY ACCESSIBILITY OF CRITICAL RESUSCITATION SUPPLIES IN THE EMERGENCY DEPARTMENT AT KIGALI UNIVERSITY TEACHING HOSPITAL

Abstract

bstract Timely Accessibility of Critical Resuscitation Supplies at Kigali University Teaching Hospital (CHUK) Introduction The effective preparation for the management of critically ill patients requires trained staff and adequate supplies. Limited research exists on the impact of critical supply shortages and assessment of why and when supplies are lacking at emergency departments within low –Middle income countries (LMICs). Methods This is a prospective 3-month observational single-centered study done at CHUK, at a tertiary level hospital in Kigali Rwanda from October to December 2018. We documented the usage of different supplies from a backup stock, which were employed when the hospital could not provide the desired item. We recorded the supplies used, severity of the patient’s illness, and when and why the supplies were needed. Results The most commonly lacking items that were identified during the study included atropine, ketamine, calcium gluconate, diazepam, mannitol, potassium chloride, povidone, urine pregnancy and urine dipstick. The reasons for lacking supplies included emergency department being out of stocks (28%), laboratory accessibility (27.6%), the hospital out of stocks (19.9%), inaccessibility of supplies (19.4%), lack of ability to pay (3%) and not on hospital formulary (2%). The backup supplies were accessed most frequently between 12:00 and 14:00, regardless of the day of the week. Conclusion This study characterized gaps in the continuous availability of emergency department supplies through provision of back up supplies and monitoring of their utilization patterns. This data will help strengthen the supply process ensuring uninterrupted access to critical supplies. Future studies on the patient’ outcomes is recommended.