Patient-Caretaker Education Improves Neurosurgical Outcomes in Uganda

June 29, 2020

Racheal is recovering from surgery at Mulago National Referral Hospital in Uganda. Her brother hovers by her side, worried that she hasn’t been eating. A nurse explains how to use a feeding tube safely and effectively, but he’s skeptical. “Isn’t that tube harmful?” he asks. “I hear that it makes patients die.”

In Uganda and other settings with a shortage of nurses, family members play a vital role in taking care of patients. Their tasks include feeding, cleaning and administering medication. However, these caretakers often have little to no knowledge of patient-care practices, which can be dangerous.

Led by Duke Neurosurgery professors Tony Fuller and Michael Haglund, a Bass Connections project team has been working with Mulago Hospital to improve patient outcomes in the neurosurgery ward. In close collaboration with the local staff, student team members build and test protocols that strengthen the systems for three vital aspects of care before and after surgery: patient-caretaker education, infection control and medication management.

Last summer, the team collaborated with nurses and doctors to create a culturally competent educational video showcasing proper feeding and care techniques. Made in two languages – English and Luganda – using fictional patient Racheal as an example, the video details the proper methods to feed patients and highlights hand sanitation practices and ward policies. A wall-mounted screen plays the video on a loop in order to ensure that the information reaches everyone in the ward.

Bass Connections team members in Kampala, Uganda, in 2019.
Bass Connections team members in Kampala, Uganda, in 2019.

Other patient-caretaker education projects include using a texting intervention to remind caretakers to turn patients in order to prevent bedsores and creating educational posters outlining feeding techniques to prevent aspiration. These interventions have made a positive impact on the ward. For example, the SMS text reminders nearly doubled patient turning rates.

To read more, check out this team’s submission for the Fortin Foundation Bass Connections Virtual Showcase.

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