A qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providers
Abstract Background The Russian Federation’s invasion of Ukraine is characterized by indiscriminate attacks on civilian infrastructure, including hospitals and clinics that have devastated the Ukrainian health system putting trauma care at risk. International healthcare providers responded to the ne...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Conflict and Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13031-024-00570-z |
| _version_ | 1797276508902916096 |
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| author | Lynn Lieberman Lawry Jessica Korona-Bailey Luke Juman Miranda Janvrin Valentina Donici Iurii Kychyn John Maddox Tracey Perez Koehlmoos |
| author_facet | Lynn Lieberman Lawry Jessica Korona-Bailey Luke Juman Miranda Janvrin Valentina Donici Iurii Kychyn John Maddox Tracey Perez Koehlmoos |
| author_sort | Lynn Lieberman Lawry |
| collection | DOAJ |
| description | Abstract Background The Russian Federation’s invasion of Ukraine is characterized by indiscriminate attacks on civilian infrastructure, including hospitals and clinics that have devastated the Ukrainian health system putting trauma care at risk. International healthcare providers responded to the need for help with the increasing numbers of trauma patients. We aimed to describe their experiences during the conflict to explore the gaps in systems and care for trauma patients to refine the Global Trauma System Evaluation Tool (G-TSET) tool. Methods We conducted qualitative key informant interviews of healthcare providers and business and logistics experts who volunteered since February 2022. Respondents were recruited using purposive snow-ball sampling. Semi-structured, in-depth interviews were conducted virtually from January-March 2023 using a modified version of the G-TSET as an interview guide. Interviews were transcribed verbatim and deductive thematic content analysis was conducted using NVivo. Findings We interviewed a total of 26 returned volunteers. Ukraine’s trauma system is outdated for both administrative and trauma response practices. Communication between levels of the patient evacuation process was a recurrent concern which relied on handwritten notes. Patient care was impacted by limited equipment resources, such as ventilators, and improper infection control procedures. Prehospital care was described as highly variable in terms of quality, while others witnessed limited or no prehospital care. The inability to adequately move patients to higher levels of care affected the quality of care. Infection control was a key issue at the hospital level where handwashing was not common. Structured guidelines for trauma response were lacking and lead to a lack of standardization of care and for trauma. Although training was desired, patient loads from the conflict prohibited the ability to participate. Rehabilitation care was stated to be limited. Conclusion Standardizing the trauma care system to include guidelines, better training, improved prehospital care and transportation, and supply of equipment will address the most critical gaps in the trauma system. Rehabilitation services will be necessary as the conflict continues into its second year. |
| first_indexed | 2024-03-07T15:30:11Z |
| format | Article |
| id | doaj.art-e8e433799f9e4fc1b432b2b6f22ae0ff |
| institution | Directory Open Access Journal |
| issn | 1752-1505 |
| language | English |
| last_indexed | 2024-03-07T15:30:11Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Conflict and Health |
| spelling | doaj.art-e8e433799f9e4fc1b432b2b6f22ae0ff2024-03-05T16:31:36ZengBMCConflict and Health1752-15052024-01-011811810.1186/s13031-024-00570-zA qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providersLynn Lieberman Lawry0Jessica Korona-Bailey1Luke Juman2Miranda Janvrin3Valentina Donici4Iurii Kychyn5John Maddox6Tracey Perez Koehlmoos7Preventive Medicine and Biostatistics Department, Uniformed Services UniversityHenry M. Jackson Foundation for the Advancement of Military Medicine, Inc.Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.Preventive Medicine and Biostatistics Department, Uniformed Services UniversityBogomolets National Medical UniversityPreventive Medicine and Biostatistics Department, Uniformed Services UniversityPreventive Medicine and Biostatistics Department, Uniformed Services UniversityAbstract Background The Russian Federation’s invasion of Ukraine is characterized by indiscriminate attacks on civilian infrastructure, including hospitals and clinics that have devastated the Ukrainian health system putting trauma care at risk. International healthcare providers responded to the need for help with the increasing numbers of trauma patients. We aimed to describe their experiences during the conflict to explore the gaps in systems and care for trauma patients to refine the Global Trauma System Evaluation Tool (G-TSET) tool. Methods We conducted qualitative key informant interviews of healthcare providers and business and logistics experts who volunteered since February 2022. Respondents were recruited using purposive snow-ball sampling. Semi-structured, in-depth interviews were conducted virtually from January-March 2023 using a modified version of the G-TSET as an interview guide. Interviews were transcribed verbatim and deductive thematic content analysis was conducted using NVivo. Findings We interviewed a total of 26 returned volunteers. Ukraine’s trauma system is outdated for both administrative and trauma response practices. Communication between levels of the patient evacuation process was a recurrent concern which relied on handwritten notes. Patient care was impacted by limited equipment resources, such as ventilators, and improper infection control procedures. Prehospital care was described as highly variable in terms of quality, while others witnessed limited or no prehospital care. The inability to adequately move patients to higher levels of care affected the quality of care. Infection control was a key issue at the hospital level where handwashing was not common. Structured guidelines for trauma response were lacking and lead to a lack of standardization of care and for trauma. Although training was desired, patient loads from the conflict prohibited the ability to participate. Rehabilitation care was stated to be limited. Conclusion Standardizing the trauma care system to include guidelines, better training, improved prehospital care and transportation, and supply of equipment will address the most critical gaps in the trauma system. Rehabilitation services will be necessary as the conflict continues into its second year.https://doi.org/10.1186/s13031-024-00570-zUkraineTrauma systemsEmergency medical systemsConflict health |
| spellingShingle | Lynn Lieberman Lawry Jessica Korona-Bailey Luke Juman Miranda Janvrin Valentina Donici Iurii Kychyn John Maddox Tracey Perez Koehlmoos A qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providers Conflict and Health Ukraine Trauma systems Emergency medical systems Conflict health |
| title | A qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providers |
| title_full | A qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providers |
| title_fullStr | A qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providers |
| title_full_unstemmed | A qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providers |
| title_short | A qualitative assessment of Ukraine’s trauma system during the Russian conflict: experiences of volunteer healthcare providers |
| title_sort | qualitative assessment of ukraine s trauma system during the russian conflict experiences of volunteer healthcare providers |
| topic | Ukraine Trauma systems Emergency medical systems Conflict health |
| url | https://doi.org/10.1186/s13031-024-00570-z |
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