Table 5.
Responses to Questions on Professional Practice
| Hospital
|
||||||
|---|---|---|---|---|---|---|
| Variable | Mulago, Uganda N = 23 |
CHU Kamenge, Burundi N = 5 |
Kenyatta, Kenya N = 26 |
Muhimbili, Tanzania N = 17 |
CHU Kigali, Rwanda N = 14 |
Chi P value |
| Preanesthetic surgical check list use | .001 | |||||
| Always | 0 | 0 | 5 (19.23) | 11 (64.71) | 5 (35.71) | |
| Never | 23 (100) | 5 (100) | 21 (80.77) | 6 (35.29) | 9 (64.29) | |
| Perform preanesthetic evaluation | .001 | |||||
| Always | 20 (86.96) | 5 (100) | 21 (80.77) | 8 (47.06) | 4 (30.77) | |
| Never | 3 (13.04) | 0 | 5 (19.23) | 9 (52.94) | 9 (69.23) | |
| Check preoperative informed consent | .001 | |||||
| Always | 21 (91.30) | 0 | 23 (88.46) | 17 (100) | 13 (92.86) | |
| Never | 2 (8.70) | 5 (100) | 3 (11.54) | 0 | 1 (7.14) | |
| Presence of an assistant to give cricoid pressure | .001 | |||||
| Always | 1 (4.35) | 5 (100) | 11 (42.31) | 11 (64.71) | 2 (14.29) | |
| Never | 22 (95.65) | 0 | 15 (57.69) | 6 (35.29) | 12 (85.71) | |
| Continuous education (CPD) in obstetric anesthesia | .001 | |||||
| Always | 0 | 0 | 11 (42.31) | 2 (11.76) | 0 | |
| Never | 23 (100) | 5 (100) | 15 (57.69) | 15 (88.24) | 13 (100) | |
| Adequate supervision | .001 | |||||
| Always | 4 (17.39) | 4 (80.00) | 20 (76.92) | 7 (41.18) | 4 (28.57) | |
| Never | 19 (82.61) | 1 (20.00) | 6 (23.08) | 10 (58.82) | 10 (71.43) | |
| Intraoperative cardiac arrest occurrence in last 1 year (obstetric cases) | .001 | |||||
| Yes | 12 (52.17) | 5 (100) | 7 (26.92) | 11 (64.71) | 12 (85.71) | |
| No | 11 (47.83) | 0 | 19 (73.08) | 6 (35.29) | 2 (14.29) | |
| Supervision for complicated conditionsa | .002 | |||||
| Always | 4 (17.39) | 0 | 16 (61.54) | 7 (41.18) | 2 (14.29) | |
| Never | 19 (82.61) | 5 (100) | 10 (38.46) | 10 (58.82) | 12 (85.71) | |
| Access to new anesthetic technologyb | .001 | |||||
| Always | 3 (13.04) | 1 (20.00) | 21 (80.77) | 7 (43.75) | 4 (28.57) | |
| Never | 20 (86.96) | 4 (80.00) | 5 (19.23) | 9 (56.25) | 10 (71.43) | |
| >50% of patients that are evaluated in the operating roomc | .013 | |||||
| Always | 23 (100) | 2 (40.00) | 21 (80.77) | 15 (88.24) | 11 (78.57) | |
| Never | 0 | 5 (19.23) | 2 (19.23) | 2 (11.76) | 3 (21.43) | |
| Anesthetic practice complies with clinical guidelinesd | .095 | |||||
| Yes | 15 (65.22) | 4 (100) | 9 (36.00) | 9 (52.94) | 8 (57.14) | |
| No | 8 (34.78) | 0 | 16 (64.00) | 8 (47.06) | 6 (42.86) | |
| Patients taken care of after surgery for >0 minutes | .001 | |||||
| Always | 0 | 0 | 20 (76.92) | 14 (82.35) | 13 (92.86) | |
| Never | 23 (100) | 5 (100) | 6 (23.08) | 3 (17.65) | 1 (7.14) | |
| Availability of ICU services for obstetric patients | .001 | |||||
| Always | 2 (8.70) | 0 | 20 (76.92) | 5 (29.41) | 10 (71.43) | |
| Never | 21 (91.30) | 5 (100) | 6 (23.08) | 12 (70.59) | 4 (28.57) | |
Abbreviations: CHU, Centre Hospitalier Universite; CPD, Continuous Professional Development; ICU, intensive care unit.
a
Support supervision from a senior consultant for anesthesiologists or even from an anesthesiologist – nonphysician.
b
Access to advances in obstetric anesthesia such as epidurals for cesarean delivery or labor analgesia.
c
>50% of patients first evaluated preoperatively in the operating room.
d
Clinical guidelines for spinal anesthesia: aseptic technique.