tep 1 Competencies have been designed to provide staff with the core skills required to care for a critically ill patient safely, whilst under supervision. It is expected that Step 1 competencies will be completed prior to commencing an academic
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critical care programme.
Steps 2 & 3 Competencies have been designed to further develop your essential critical care skills and will require enhanced theoretical knowledge to underpin your practice. It is anticipated that Steps 2 & 3 competencies will be undertaken whilst undertaking an academic critical care programme.
Step 4 Competencies have been designed to provide staff with the core skills required to take charge in a critical care unit; building management and leadership capability into your professional development, to demonstrate safe and effective coordination and prioritisation of unit workload, workforce and resources.
You can downlaod any of the Steps Competency Documents from this link
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A Joint Position Statement of the Indian Society of Critical Care Medicine (ISCCM) and the Indian
Association of Palliative Care (IAPC)
Indian Jo
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urnal of Critical Care Medicine September 2014 Vol 18 Issue 9
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Patient safety standards are critical for the establishment and assessment of patient safety programmes within hospitals. This third edition of the Patient safety assessment manual provides an updated set of standards and assessment criteria that re
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flect current best practice and WHO guidance. The manual will support the implementation of patient safety assessments and improvement programmes within hospitals as part of the Patient Safety Friendly Hospital Framework to ensure that patient safety is prioritized and facilities and staff implement best practices. The manual is a key tool for use by professional associations regulatory accrediting or oversight bodies and ministries of health to improve patient safety.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of car
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e for critically ill patients, especially in low-staffed and low-resourced settings, and mortality rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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Nursing Times [online]; 117: 11, 18-21.
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countri
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es and often fail to provide comprehensive, people-centred, integrated care. We analysed the primary health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety a
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nd quality of care. Such services are also essential for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities for personal autonomy and self-realization. To prom
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ote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
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The objective of Critical Considerations and Actions for Achieving Universal Access to Sexual and Reproductive Health in the Context of Universal Health Coverage through a Primary Health Care Approa
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ch is to provide guidance to WHO Member States for ensuring progress towards universal access to comprehensive sexual and reproductive health (SRH) in the context of primary health care (PHC)- and universal health coverage (UHC)-related policy and strategy reforms.
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[Preface]. For more than forty years Primary Health Care (PHC) has been recognized as the cornerstone of an effective and responsive health system. The Alma-Ata Declaration of 1978 reaffirmed the right to the highest attainable level of health, with
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equity, solidarity and the right to health as its core values. It stressed the need for comprehensive health services, not only curative but services that addressed needs in terms of health promotion, prevention, rehabilitation and treatment of common conditions. A strong resolutive first level of care is the basis for health system development [...] The Pan American Health Organization/World Health Organization (PAHO/WHO) has supported the countries in the establishment of interprofessional PHC teams, in the transformation of health education and in building capacity in the strategic planning, and management of human resources for health. Nursing can play a critical role in advancing PHC. New profiles such as the advanced practice nurses, as discussed in this document, can be fundamental in this effort, and in particular, in health promotion, disease prevention and care, especially in rural and underserved areas.
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Infectious disease outbreaks and epidemics are increasing in frequency, scale and impact. Health care facilities can amplify the transmission of emerging infectious diseases or multidrug-resistant organisms (MDRO) within their settings and communiti
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es. Therefore, evidence-based infection prevention and control (IPC) measures in health care facilities are critical for preventing and containing outbreaks, while still delivering safe, effective and quality health care. This toolkit is intended to support IPC improvements for outbreak management in all such facilities, both public and private throughout the health system. Specifically, this document systematically describes a framework of overarching principles to approach the preparedness, readiness and response outbreak management phases. The document also provides a toolkit of resource links to guide specific actions for each infectious disease and/or MDRO outbreak management phase at any health facility. This document is specifically tailored to an audience of stakeholders who establish and monitor health care facility-level IPC programs including: IPC focal points, epidemiologists, public health experts, outbreak response incident managers, facility-level IPC committee(s), safety and quality leads and managers, and other facility level IPC stakeholders.
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Every day, health-care providers are being attacked, patients discriminated against, ambulances held up at checkpoints, hospitals bombed, medical supplies looted and entire communities cut off from critica
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l services around the world.
Between January 2012 and December 2014, the ICRC documented nearly 2,400 violent incidents against health care in 11 countries experiencing armed conflict or other violence. In over 90% of cases, local health-care providers were affected, seriously threatening the effectiveness and sustainability of national health-care systems. These numbers might well just be the tip of the iceberg
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Sexual violence is a major problem in South Africa, with studies showing that up to one in four women have been raped in their lifetime.
Yaya et al. BMC Pregnancy and Childbirth (2018) 18:194
Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services
and fertility control methods, is one of the most
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critical challenges for public health sector. There are significant
disparities in maternal health care indicators across many geographical locations, maternal, economic, sociodemographic
factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization
level of maternal health care, and examined disparities in the determinants of major maternal health outcomes
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AJOL, Vol.92 No.2; There is a low bed capacity in ICUs compounded by a universal deficit in human resource capacity and support infrastructure for the critical care services. Regionalisation, increa
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sed funding and more training opportunities for critical are
services by the regional and central governments will go a long way in alleviating these challenges
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Nurses are key players in health promotion and disease prevention and the backbone of health care systems worldwide. Nurses work on the front lines of disease prevention, health promotion, and health management and are often the unsung heroes in hea
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lth care facilities and emergency response. Despite the critical role they play in health care, there is a nursing shortage across the world that will affect the delivery of competent nursing care. This document highlights key action points for targeted investment in the nursing workforce and calls on Member States to strengthen nursing within the context of their own country efforts.
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22 April 2022, This document provides updated interim recommendations on the use of masks by health workers providing care to patients with suspected or confirmed COVID-19. This update is prompted by new evidence around mask use and COVID-19 transmi
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ssion, as well as the emergence of variants of concern including Omicron. Masks continue to be a critical tool to prevent the spread of COVID-19. These interim guidelines supersede the recommendations provided in the WHO recommendations on mask use by health workers, in light of the Omicron variant of concern published on 22 December 2022.
WHO continually evaluates the emerging evidence and will review these interim recommendations within two months and issue new guidance as needed.
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