Operative care at_the_hospital_shabani

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What is necessary to provide good care for persons with SB and H? Operative care / hospital set up Dr H. K. Shabani MD PhD FCS Neurosurgeon, Muhimbili Orthopedic Institute

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  • 1.What is necessary to provide good care for persons with SB and H? Operative care / hospital set up Dr H. K. Shabani MD PhD FCS Neurosurgeon, Muhimbili Orthopedic Institute

2. Hospitals treating NTD children in Tanzania BUGANDOHydom Christian Health Centre (Luth Ref Hosp)Seliani hospKCMCMOI 2005 todate. ( 200 patients)Muhimbili Medical Centre ?;CCBRT 1996-2005 ( 102 patients) 3. NTD Rx CENTRESMOI hydrocephalus seriesMOI receives patients from all overthe countryMKOA 40 30 201000 km Frequency 10 0 do amsiki armmruta a iri kn a pw zru ita ra ng m ya w gobobetw dods m zn aus vu ng ngkwjaan or an a idmarhmro ma z aoa aaMKOA 4. Why only few hospitals in Tz are involved in SB/H treatment? 5. Prerequisite for SB/H good treatment outcome at the hospital settings: Patient selection Proper pre operative work-up SMART treatment guidelines and proper surgical procedure Proper post-operative follow-up and in-patient care Right time for discharge and organized outpatient follow up plan 6. Prerequisite for SB/H good treatment outcome at the hospital settings: Patient selection Proper pre operative work-upLate VS Early presentation Nutritional status SMART treatment guidelines and proper surgical procedure Co morbidity ( pneumonia, septicemia etc) Proper post-operative follow-up and in-patient care Right time for discharge and organized outpatient follow up plan 7. Prerequisite for SB/H good treatment outcome at the hospital settings: Patient selection Proper pre operative work-up Lab facility including staff Imaging facility ultrasound/ CT scan SMART treatment guidelines and proper surgical procedure Consent for surgery Proper post-operative follow-up and in-patient care Teamwork anesthetist, surgeon, Right time for discharge and organized outpatient follow up plan theatre nurse, supporting staffs etc Theatre facility 8. Prerequisite for SB/H good treatment outcome at the hospital settings: Patient selection Proper pre operative work-up SMART treatment guidelines and proper surgical procedure Updating surgical treatment guidelines in order to Proper post-operative follow-up and in-patient careminimize VP shunt infections, and to ensuregood outcome Right time for discharge and organized outpatient follow up plan CME to ensure quality care 9. SMART treatment guidelines and proper surgical procedure Repair achieved in one stage operation Pre surgeryPost surgery8/12 old2yr old Occipital encephalocoele 10. SMART treatment guidelines and proper surgical procedure Sometimes repair requires multistage operations? Cosmesis CSF leak Pre surgeryPost surgery #1#2 etc Frontoethmoidal encephalocoele 11. SMART treatment guidelines and proper surgical procedure Multidisciplinary approach in coordination sometimes is required Thoracic SB and TEV child 12. Prerequisite for SB/H good treatment outcome at the hospital settings: Intensive care set up, treatment guidelines Patient selection Committed supporting staff and collaborating care professionals Wound care Proper preoperative work-upNutritionSMART treatment guidelines and proper surgical procedure Proper post-operative follow-up and in-patient care Right time for discharge and organized outpatient follow up plan 13. Prerequisite for SB/H good treatment outcome at the hospital settings: Established engagement with collaborating team e.g. Patient selection physiotherapy, club foot clinic, CBR worker etc Proper counseling ensures good follow up Proper pre operative work-up SMART treatment Database management to ensure Rx continuation / guidelines and proper surgical procedure evaluation and dissemination Proper post-operative follow-up and in-patient care Right time for discharge and organized outpatient follow up plan 14. Suggestions?