Compliance with haemodialysis practice guidelines in Egypt.

Evidence- and consensus-based clinical practice guidelines for haemodialysis have recently been developed in Egypt. This study aimed to measure compliance with the guidelines in a sample of 16 government hospitals in Cairo and Giza governorates. Each haemodialysis unit was visited to assess the haemodialysis unit and patient care practices for all patients under dialysis at the time of the visit. The mean percentage compliance with haemodialysis guidelines among all study hospitals was 59.3% (SD 11.2%) overall. Within the 5 separate domains, compliance was: 58.8% (SD 12.4%) for personnel, 68.5% (SD 16.0%) for patient care practices, 61.3% (SD 15.4%) for infection prevention and control, 51.5% (SD 18.2%) for the facility and 56.5% (SD 7.1%) for documentation/ records. There were no statistically significant differences between Cairo and Giza governorates except for facility measures which were slightly better in Giza. Overall, compliance with the developed practice guidelines for haemodialysis in Egypt was not satisfactory and was not uniform across facilities.

Compliance with haemodialysis practice guidelines in Egypt

Evidence- and consensus-based clinical practice guidelines for haemodialysis have recently been developed in Egypt. This study aimed to measure compliance with the guidelines in a sample of 16 government hospitals in Cairo and Giza governorates. Each haemodialysis unit was visited to assess the haemodialysis unit and patient care practices for all patients under dialysis at the time of the visit. The mean percentage compliance with haemodialysis guidelines among all study hospitals was 59.3% [SD 11.2%] overall. Within the 5 separate domains, compliance was: 58.8% [SD 12.4%] for personnel, 68.5% [SD 16.0%] for patient care practices, 61.3% [SD 15.4%] for infection prevention and control, 51.5% [SD 18.2%] for the facility and 56.5% [SD 7.1%] for documentation/ records. There were no statistically significant differences between Cairo and Giza governorates except for facility measures which were slightly better in Giza. Overall, compliance with the developed practice guidelines for haemodialysis in Egypt was not satisfactory and was not uniform across facilities

Are patients and healthcare providers satisfied with health sector reform implemented in family health centres?

BACKGROUND: Patients' and healthcare providers' satisfactions are important outcomes for any healthcare programmes. In Egypt, the Health Sector Reform Program (HSRP) has been implemented since 1999 in primary healthcare (PHC) centres adopting the family health approach. OBJECTIVES: To assess the clients' satisfaction towards the overall health services provided by health centres affiliated to HSRP and to evaluate the satisfaction of healthcare providers, physicians, nurses and social workers. METHODOLOGY: Four reformed PHC units were compared with four non-reformed units in the Alexandria governorate regarding patients' and providers' satisfactions. Assessment of the satisfaction was done using survey questionnaire and focus group discussion. The provider survey questionnaire was carried out on all providers working in the selected units. Focus group discussion was done in one reformed health unit and another non-reformed unit. RESULTS: The current study showed that providers in the reformed PHCs were more satisfied than providers in non-reformed PHCs regarding availability of equipments, job satisfaction and income satisfaction. No significant differences were noticed between both groups regarding social relations with either colleagues or directors. The patient satisfaction was higher in accredited family health units compared to non-accredited units in all aspects: cleanness, doctors and nurses, waiting area and waiting time. During the focus group discussion, patients in the accredited PHCs expressed their satisfaction regarding the cleanness, privacy, attitude of doctors and nurses as well the waiting area and waiting time. CONCLUSION: Implemented HSRP in PHC units has had positive implications regarding patients' and providers' satisfactions in most areas studied.

Development of practice guidelines for hemodialysis in Egypt.

Although hemodialysis is the main modaility of treatment of end-stage renal disease, no practice guidelines are available in Egypt. Applying international guidelines for hemodialysis would not be suitable or feasible, because of different health system and lack of resources. The aim of this project was the development of evidence- and consensus-based clinical practice guidelines for hemodialysis in Egypt. The Egyptian guidelines were adopted from the standards developed by The College of Physicians and Surgeons of Alberta (Canada), The National Kidney Foundation (USA), The Clinical Standards Board for Scotland (Scotland), and The College of Physicians and Surgeons of Ontario (Canada). In addition, the guidelines published in Oxford Handbook of Dialysis were reviewed. Thereafter, a panel of Egyptian experts in the field of nephrology and hemodialysis was selected and invited to participate in this project. The Delphi technique was applied to build up the consensus among the experts on the formulated guidelines. The final version of the Egyptian Hemodialysis Practice Guidelines included five main sections; personnel, patient care practices, infection prevention and control, facility, and documentation/records. A consensus on practice guidelines for hemodialysis has been successfully produced and is supported by levels of evidence. The 12 Egyptian experts who participated in the Delphi technique and the reviewers assured the completeness and acceptability of the developed practice guidelines. Also, including experts from the university hospitals together with the Directorates of Cairo and Giza Health Affairs of the Egyptian Ministry of Health (MOH) avoided conflicts between clinical recommendations and feasible application in the MOH hemodialysis facilities.