The Burden on Emergency Centres to Provide Care for Critically Ill

Patients in Addis Ababa, Ethiopia

Journal Reading Requirement

College of Health Sciences Education
Bachelor of Science in Nursing
University of Mindanao
Davao City

Submitted to:
Mr. John Anthony Magallanes, RN
NCM118 RLE

Submitted by:
Elaiza Faith N. Catayas
BSN 4 Code 3000

December 7, 2023
 Summary

The availability of critical care beds is scarce in developing countries. Given

the scarcity of critical care hospital beds in Africa, emergency centers (ECs) are
increasingly charged with caring for critically ill patients for extended periods of time.
Many patients were transferred from the EC to other departments in the hospital, but
then returned to the EC due to a shortage of ICU beds.

The objective of the study was to improve the understanding of the nature and
outcomes of critically ill patients with prolonged treatment times of more than six
hours in two ECs in Addis Ababa, Ethiopia. The study was conducted over three
months in two ECs of urban tertiary care hospitals in Addis Ababa. Structured
questionnaires were completed by six emergency and critical care nurses. EC
patients were included if they met the Society for Critical Care Medicine (SCCM)
intensive care unit (ICU) admission criteria and stayed in the EC for more than six
hours. They collected initial demographic and clinical information, data about the
patients’ clinical course in the EC, and data regarding the patients’ disposition. They
used descriptive statistics for analysis.

The result of the study shows that the most common categories of illness
were neurological disease and cardiovascular disease. The most frequent
aetiologies of critical illness were severe head trauma and severe sepsis with multi-
organ failure. A total of 94 patients died in the EC, while 86 were discharged directly
from the EC without hospital admission. In addition, Emergency Cares in Addis
Ababa face a heavy burden in caring for a large number of critically ill patients over a
long period of time, with relatively high mortality rates. Moreover, it emphasizes the
need for improved critical care capacity, both in the EC and in the ICU. The lack of
ICU space will also increase EC overcrowding in Ethiopia and will likely contribute to
poor patient satisfaction and clinical outcomes. This could potentially lead to burnout
and attrition among providers. One possible solution would be to develop
intermediate care units or transition areas where patients can be closely monitored
and treated until an ICU bed becomes available.Thus, the findings should promote
supporting emergency centers to strengthen and expand ICU capacity to provide
appropriate critical care services.
 Reflection

According to the journal, due to the shortage of ICU beds, all of these patients
required prolonged stays in the EC, potentially hampering their clinical outcomes and
placing a significant burden on EC resources. The number of hospital beds directly
correlates with the volume of patients that the hospital can accommodate. In
situations where there is a shortage of beds, patients may experience delays in
receiving necessary medical attention. This can impact patient safety and outcomes.
Adequate bed availability ensures that patients can be admitted promptly, and
nurses can deliver timely and appropriate care. It also impacts the overall efficiency
of healthcare delivery. With an optimal number of beds, nurses can manage patient
flow more effectively, reducing overcrowding, wait times, and potential bottlenecks in
the healthcare system. Moreover, Adequate bed availability contributes to a better
patient experience. Patients are more likely to receive prompt attention, experience
shorter wait times, and have a more positive perception of the healthcare facility
when there are enough beds to meet their needs. Therefore, the number of hospital
beds is a critical factor that directly affects the workload, efficiency, and overall
effectiveness of nurses in delivering patient care. It plays a pivotal role in ensuring
patient safety, maintaining quality care, and supporting nurses in their daily
responsibilities.

Reference:

Sultan, M., Mengistu, G., Debebe, F., Azazh, A., & Trehan, I. (2018). The burden on
emergency centres to provide care for critically ill patients in Addis Ababa,
Ethiopia. African Journal of Emergency Medicine, 8(4), 150-
154. https://doi.org/10.1016/j.afjem.2018.07.006