ABSTRACT 657

Abstract

Background and aims: The 2009 influenza A (H1N1) pandemic caused surges in numbers of critically ill patients worldwide. The Ministries of Health of several countries requested clinical guidance from World Health Organization (WHO). Aims: Development and delivery of a training course in the clinical management of adult and paediatric patients critically ill with acute respiratory and severe sepsis syndromes for use in resource-limited settings. The course targets non-specialist clinicians, emphasizing evidence-based guidance. Methods: WHO sponsored course development, piloting (2009–2013) and implementation (2013), including translation of materials International clinical experts (33), aided by professional instructional designers, contributed or reviewed the course content. Results: The 3-day course has 14 sequential learning units: early recognition, pathophysiology, oxygen therapy, influenza diagnostic testing, infection prevention and control, targeted resuscitation of septic shock, antimicrobial therapy, monitoring, lung protective ventilation, targeted sedation, liberation from mechanical ventilation, preventive care, quality improvement, ethics. Teaching materials include lectures; small-group role-play sessions, and a toolkit with protocols and checklists http://influenzatraining.org/en/). The pilot courses in Trinidad, Tobago, Indonesia, and Vietnam, showed an increase in participant knowledge (20% improvement in test scores) and they rated the content highly. The course has subsequently been sponsored in China, Uzbekistan, Azerbaijan and Tajikistan with similar improvement in local knowledge and course rating. Conclusions: It was feasible to create and deliver a course on the management of critical illness syndromes to non-specialty clinicians working in resource-limited settings. Success depended on collaboration between WHO, clinical experts, instructional designers, Ministries of Health, and local clinician leaders. Despite sustainability challenges, this course may help to strengthen low-resource healthcare systems.