Anesthesia care task sharing a clinical audit for the anesthesia care provided by anesthesia technologists in Wad Medani,Central Sudan
Introduction: The bachelor's degree in anaesthesia sciences program was implemented in Sudan in 1998 to alleviate the shortage of anaesthesiologists while minimizing the anaesthesia related complications of anaesthesia technicians' practice. In the absence of a defined scope of practice and a lack of financial and legal protection, practitioners are leaving their anaesthesia technology careers in Sudan in search of more secure careers, which has resulted in a noticeable gap in anaesthesia practice in Wad Medani, Gezira State. This study was conducted to determine the proportion of anaesthesia care tasks that were carried out by the anaesthesia technologists at four public referral hospitals in Wad Medani, Sudan. Methods: The study was a three-month cross-sectional observational clinical audit of anaesthetic services at four Gezira State Ministry of Health tertiary referral hospitals and included a number of 1559 patients. Data was gathered to describe the perioperative anaesthetic care tasks provided to surgical patients undergoing emergency or elective procedures through a questionnaire that was designed based on the definition of the American Society of Anaesthesiologists of the anaesthesia care tasks. The study began on November 3rd, 2022, and lasted three months, ending on February 2nd, 2023. Results: The analysed data showed an average of 18 cases per day. Out of the total 1559 surgical anaesthesia cases in Wad Medani, 718 (46%) of cases were carried out by anaesthesia technologists without the presence of supervising anaesthesiologists. A percentage of 65.2 of these cases were spinal anaesthesia while general anaesthesia and sedation comprised 25.6% and 9.2% respectively. In the presence of supervising anaesthesiologist, anaesthesia technologists performed over 80% of the anaesthesia care tasks. Conclusions: Anaesthesia technologists make a substantial contribution to Anaesthesia services in Wad Medani. Our results demonstrated that a considerable proportion of Anaesthesia procedures are carried out without any kind of anaesthesiologists supervision. Guidelines and protocols should be developed and implemented to govern anaesthesia practice given the resource constraints in this setting. Regular training on safe anaesthesia practice should be applied. Further research is needed on to assess the provision of anaesthesia care and the extent of surgical delay in regions of displacement.
Task sharing, Task shifting, Anaesthetic technique, Intubation, Extubation, Low- middle income countries
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