Deficiencies in education and experience in the management of acute kidney injury among Malawian healthcare workers|
Evans, R.; Rudd, P.; Hemmila, U.; Dobbie, H. & Dreyer, G.
Acute kidney injury (AKI) is a common but under-recognised disease
process, which carries a high risk of mortality or chronic complications,
such as chronic kidney disease and other organ dysfunction. Management
of AKI, however, is suboptimal, both in developed settings and in Malawi.
This is partly because of deficiencies in AKI education and training.
To establish current levels of AKI education in a range of healthcare
workers in Malawi.
An AKI symposium was held in Blantyre in March 2015. Delegates were
asked to complete a survey at the start of the symposium to assess their
clinical experience and education in the management of AKI.
From 100 delegates, 89 nurses, clinical officers, and physicians, originating
from 11 different districts, responded to the survey. Twenty-two percent
of healthcare workers (including 28% of district workers of the various
cadres and 31% of nurses) had never received teaching on any aspect
of renal disease, and 50% (including 63% of district workers and 61%
of nurses) had never received teaching specifically on AKI. Forty-four
percent did not feel confident managing AKI, and 98% wanted more
support managing patients with renal disease. Thirty-four percent
(including 55% of district workers) were unaware that haemodialysis was
available at Queen Elizabeth Central Hospital (QECH) for the treatment
of AKI and 53% (74% of district workers) were unaware that peritoneal
dialysis was available for the treatment of AKI in children. Only 33% had
ever referred a patient with AKI to QECH.
There are deficiencies in education about, and clinical experience in, the
management of AKI among Malawian healthcare workers, in addition to
limited awareness of the renal service available at QECH. Urgent action
is required to address these issues in order to prevent morbidity and
mortality from AKI in Malawi.