Evaluating Interventions Aimed at Improving Neurosurgical Patient Outcomes in Uganda (2018-2019)

Surgery was catapulted into the global health spotlight with the publication of the Lancet Commission on Global Surgery report. The report discusses the importance of projects that not only focus on provision of surgical procedures, but also the need for holistic health systems strengthening. Since 2007, Duke Global Neurosurgery and Neurology (DGNN) has been utilizing this concept of health systems strengthening to improve neurosurgical care for patients throughout Uganda. DGNN’s approach consists of provision of neurosurgical services, training, research, twinning and advocacy.

This Bass Connections project team evaluated interventions directed at impacting neurosurgical patient outcomes. The team applied its research question – Which interventions aimed at neurosurgical patients actually improve patient outcomes and are efficient and cost effective? – to three foundational areas: infection control, medication management and patient family education.

Team members contributed to the development of an intervention plan that shows intervention effectiveness and also generated data that will be utilized for improving patient care. The team increased patients’ and caretakers’ understanding of their medications, developed educational materials to build health literacy skills, deployed hand sanitizer stations and lowered the infection rate by 15-20%.

Timing

Summer 2018 – Spring 2019

Team Outputs

Infection Control from an Emic Perspective: Forming and Evaluating a Local Infection Control Team in a Low-resource Neurosurgery Ward (poster by Samantha Sadler, Anthony Fuller, Michael Haglund, Melissa Watt, presented at Bass Connections Showcase, Duke University, April 17, 2019)

Evaluating a Routine Program to Improve Patient Aspiration Rates in Mulago Hospital Neurosurgical Ward, Uganda (poster by Sherry Yang, Chinemerem Nwosu, Priyanka Rao, Amina Mohamed, Michael Haglund, Anthony Fuller, presented at Bass Connections Showcase, Duke University, April 17, 2019)

Anthony Fuller, Akash D. Patel, Kelsey Graywill, Samantha Sadler, Bruno Valan, Praruj Pant, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Michael M. Haglund. Improving Hand Hygiene through Accessibility in a LMIC Neurosurgical Ward. Manuscript in progress.

Sherry Yang, Chinemerem Nwosu, Amina Mohamed, Priyanka Rao, Sandra Martha Batakana, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Michael Haglund, Anthony Fuller. Evaluating the Feasibility of Educational Interventions to Improve Patient Caretakers’ Health Literacy in Mulago Hospital, Uganda. Manuscript in progress.