Improving Nursing Care for Burn Patients in Bangladesh: Advanced Burn Care training (March 2016)
Nursing is one of the most crucial aspects of burn care. As in many other areas of health care, nurses are the first point of contact for patients and families and play a crucial role in almost every aspect of a patient’s daily care and recovery. Nurses play a critical role in infection prevention, pain control, wound management and dressing changes, rehabilitation, and in providing support to the patient and their family in a time of great distress.
Unfortunately, despite this crucial role in the burn care team, many nurses in low and middle income countries in Asia and Africa have little or no training in burn care. Huge numbers of patients and inadequate staffing compound this problem and often make it difficult for nurses to provide the care patients require. The many challenges that nurses face can also impact their professional status and morale, impeding teamwork with other staff and directly affecting the standard of care to burn patients.
In order to address this issue, Interburns began to develop an Advanced Burn Care module in Nursing in early 2015, designed specifically for nurses working in resource-poor environments around the world. The training was developed by a diverse international team that includes nurses, surgeons, physiotherapists and a nutritionist, from Bangladesh, Ethiopia, France, Ghana, India, Nepal and the UK, with a wealth of knowledge and experience of working in a range of different health care environments. The team met twice in Accra, Ghana to finalise the content of the course ahead of its delivery in Dhaka, Bangladesh in early 2016.
One of our partners in Bangladesh is the National Institute for Burns and Plastic Surgery at Dhaka Medical College Hospital. The Institute is a massive burn unit that officially has 100 beds with numbers of staff based on that theoretical total, but typically is home to around 400-500 inpatients at any given time. With such a huge number of patients and a relatively small number of nurses, this is both one of the highest priorities and one of the most challenging environments in the world to improve nursing care in burns. The first ABC Nursing training was held here from the 28th February to the 5th of March 2016.
The programme was run by a diverse international teaching faculty that included nurses from around the world. As many Bangladeshi nurses are not fluent English speakers, most of the programme was translated in Bengali/Bangla by local faculty. The training was deliberately designed with a high number of practical sessions to ensure local staff could learn effectively.
The five days of training covered all key aspects of nursing care and were designed to build on the foundation of the Interburns ‘Essential Burn Care’ course, which all participants had previously completed. Topics included anatomy and physiology of the Skin, the pathophysiology of burns, paediatric care, assessment, hand washing and infection prevention, analgesia and pain control, nutrition, as well as key non-clinical topics such as teamwork, simple research, and service improvement.
Local physiotherapists trained in last year’s Advanced Burn Care programme on Rehabilitation also taught practical sessions on the basics of rehabilitation – positioning and mobilising patients properly to prevent disability, scar management and massage, and making and using some simple splints. The nurses worked directly with a variety of patients in the dressing room, wards and classroom. One session focused on burn survivors, with the participants breaking into small groups to talk to survivors about their journey and how they have come to terms with their injuries.
ABC Nursing was a great success, mainly thanks to the efforts of our highly experienced international faculty, shown below:
From left to right:
- Sheila Adoe Addison, Korle-Bu teaching Hospital, Ghana
- Pratibha Sharma, Choithram Hospital and Research Centre, India
- Nara Devi Bariya, National Trauma Hospital, Nepal
- Negat Woldehawariat Chamiso, Yekatit Hospital, Ethiopia
- Dominique Navet, Welsh Centre for Burns and Plastic Surgery, UK
- Sarah Reavenall, Welsh Centre for Burns and Plastic Surgery, UK
- Caroline Kilpatrick, Glasgow Royal Infirmary, UK
- Hridita Mustafiz, Acid Survivors Foundation, Bangladesh
- Kamrul Hassan, Acid Survivors Foundation, Bangladesh (crouching)
- David Acton, IT volunteer, UK (not shown)
Interburns would like to thank our volunteer faculty for all their hard work both at the training and over a number of months to develop and organise the programme. We would also like to thank our local partners, the National Institute for Burns and Plastic Surgery, Acid Survivors Foundation and the Bangladeshi Society for Burn Injuries for their help in organising the training, with particular thanks to Dr Saidur Rahman and his colleagues at ASF and Dr Papon at NIBPS.
Interburns would also like to offer our sincere thanks to the UK Department for International Development for funding our ongoing programme in Bangladesh and Nepal.