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Impacting Many Through Training a Few

Bui Thi Thuy is the chief nurse at National Children's Hospital in Hanoi, Vietnam.

During this COVID-19 season, while REI's short-term volunteer teams are unable to travel to Vietnam, it is good to reflect on the progress being made in health care there as a result of earlier investment in training. One example of this is peripheral intravenous (IV) and central line management.

This is a story some years in the making. In 2016 Dr. Elaine Goehner, our Mixed Medical Team Leader, invited friend and colleague Prof. Dayna Holt, an IV specialist who also works at Azusa Pacific University (APU, a longtime REI partner), to participate in our fall trip.

During her stay, Dayna came alongside the nursing staff at National Children’s Hospital (NCH) in Hanoi to provide training in better IV management practice (among other things). (NCH, by the way, is huge. Each year NCH provides treatment for nearly 40,000 in-patients, 350,000 out-patients, and performs about 6,000 major surgical operations. It also regularly conducts scientific research and training in pediatrics.) Dayna’s two weeks at NCH were good, but all parties agreed that more training was needed!

At the same time the School of Nursing at APU was providing an annual 8-week leadership course for hand-picked nurse leaders from overseas. Two or three nurse leaders would come to southern California for this course, held in the spring of each year, providing for REI follow-up in the fall. One of the curriculum requirements was for each participant to bring a project idea, which would be developed and refined through one-on-one mentoring.

Among the participants from NCH was Bui Thi Thuy, Chief Nurse at NCH. Thuy’s proposed project was to develop an IV management curriculum, something that had not yet been developed in Vietnam. This curriculum project was completed and approved by the APU faculty, and Thuy returned to Hanoi.

Thuy presented her proposed curriculum to the Director of NCH for his review. It was also presented to the hospital Board and eventually found its way clear up to the Ministry of Health, which soon adopted some parts of the curriculum for national implementation.

With the seal of approval in hand, Thuy immediately began training the 800 nurses at NCH, together with colleague and former Chief Nurse, Hoa Cao Thi, herself a graduate of the APU leadership course.

Thuy presenting at National Children's Hospital

Here is Thuy’s report:

"In May, 2020, we held workshops to share knowledge about IV peripheral to all clinical nurses in our hospital (800 nurses). Our teaching focused on catheter insertion, fixation, and maintenance of IV peripheral care to ensure against infection, how to prepare the IV medications to ensure safety, and infiltration and extravasation management. Prof. Dien, who is the Vice-Director of the hospital, nursing officers and IV Team members attended all of the workshops. We discussed together our commitment to apply this to our patient care practices.

In June, 2020, we scheduled IV Team members to guide the practice in all clinical departments (3 trainers per group, with each group having a key leader). We divided clinical nurses into small groups to guide them effectively, making sure every nurse got to practice the procedures.

From July up to the present, we have been going to each department to support them, using checklists to monitor compliance. If any of the clinical departments have difficulties, I delegate Hoa or Hanh or Nhan to go there and find out the cause and re-instruct if needed.

I usually attend meetings with the NCH Infection Control Council every Friday afternoon to review infection indicators. If there is a case of Clabsi [A central line-associated bloodstream infection] that might be related to IV peripheral , we will analyze the cause and learn the lessons from experience.

Through several hard months, we all feel happy and proud of what we are doing for the safety of our patients. Thank you so much for sharing your knowledge and skills and for inspiring us to make positive changes towards the best children's health."

A young beneficiary of IV training in Vietnam

We at REI are happy and proud too. This is what we are all about. This is what we hope to see. Professional help and personal hope, shared with noble-hearted persons who will use this information and training to better their people. It couldn’t happen without the dedication and hard work of our Vietnamese friends. To them goes all the credit! But we can sometimes serve as a catalyst for genuine, productive change, as we seek our goal - "building people to build nations"!

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