A comparative analysis of intravenous infusion methods for low-resource environments

Introduction

Intravenous (IV) therapy is a crucial aspect of care for the critically ill patient. Barriers to IV infusion pumps in low-resource settings include high costs, lack of access to electricity, and insufficient technical support. Inaccuracy of traditional drop-counting practices places patients at risk. By conducting a comparative assessment of IV infusion methods, we analyzed the efficacy of different devices and identified one that most effectively bridges the gap between accuracy, cost, and electricity reliance in low-resource environments.

Methods

In this prospective mixed methods study, nurses, residents, and medical students used drop counting, a manual flow regulator, an infusion pump, a DripAssist, and a DripAssist with manual flow regulator to collect normal saline at goal rates of 240, 120, and 60 mL/h. Participants' station setup time was recorded, and the amount of fluid collected in 10 min was recorded (in milliliters). Participants then filled out a post-trial survey to rate each method (on a scale of 1 to 5) in terms of understandability, time consumption, and operability. Cost-effectiveness for use in low-resource settings was also evaluated.

Results

The manual flow regulator had the fastest setup time, was the most cost effective, and was rated as the least time consuming to use and the easiest to understand and operate. In contrast, the combination of the DripAssist and manual flow regulator was the most time consuming to use and the hardest to understand and operate.

Conclusion

The manual flow regulator alone was the least time consuming and easiest to operate. The DripAssist/Manual flow regulator combination increases accuracy, but this combination was the most difficult to operate. In addition, the manual flow regulator was the most cost-effective. Healthcare providers can adapt these devices to their practice environments and improve the safety of rate-sensitive IV medications without significant strain on electricity, time, or personnel resources.

Exploring Complicity of Cervical Cancer Screening in Malawi: The Interplay of Behavioral, Cultural, and Societal Influences

Objective

Cervical cancer is preventable, and early diagnosis is possible using low-cost technologies, but a scant number of women receive cancer screening in Malawi. This study aims to identify facilitators and barriers that influence the uptakes of cervical cancer screening behavior in Malawi.

Methods

A rapid ethnographic approach with the goal of optimizing planning for a future intervention study was utilized. Data were collected from three focus groups and seven individual interviews with adults in their communities, stakeholders, and health-care providers.

Results

Three categories (sociocultural influences, access to the health-care system, and individual factors) have emerged as facilitators or barriers to cervical cancer screening among Malawian women. The findings also showed that cervical cancer screening behavior is situated socially through cultural and health-care services of a given community.

Conclusions

Cancer screenings are only sought when illness symptoms persist or worsen. Awareness and knowledge of cervical cancer and cervical cancer screening is low among both health-care providers and the general population. Health-care systems are donor driven and focus on a single disease, health-care access is the greatest challenge to cervical cancer screening, and health-care providers are not adequately prepared to work for rapid increase in the prevalence of cervical cancer. Integrating cervical cancer screening into the existing health-care system is sustainable way forward, and nurses prepared to handle cervical cancer management can play an essential role to promote cervical cancer screening in a health resource-constrained setting.

Cancer Screening and Diagnostic Tests in Global Contexts: Case Study and Concept Analysis

Objective:

Although the purposes and outcomes of screening and diagnostic tests are different, they are often confused. Therefore, it is important to delineate the clinical concept of cancer screening tests to be clear in our communication not only among healthcare professionals but also with client populations. The aim of this study is to both describe and analyze the concept of cancer screening and explain their practical meaning in global contexts.

Methods:

Comparative case studies of cervical and liver cancer screening tests were used as the basis for developing an understanding of a specific concept (phenomenon) of cancer screening and for delineating the relationships between factors that cause screening to occur.

Results:

A cancer screening is defined as an action taken by both the patient and health-care provider to detect a possible pre-cancerous condition among healthy and asymptomatic individuals who are at sufficient risk of a specific disorder to warrant further investigation or treatment. The case study-based concept analysis has been shown to be useful for improving our understanding of the multi-dimensional nature of the concept in global contexts.

Conclusions:

New paradigms maximizing participation in cancer screening to detect diseases before symptoms are manifested rather than focusing on diagnosis and treatment of symptomatic infectious diseases need to be developed and implemented.