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Nursing care at MSF | Collections | MSF Science Portal
Nursing care at MSF

Nursing care at MSF

Nurses spend more time at the bedside than any other healthcare workers and are a cornerstone of quality, person-centered clinical care in MSF health facilities. Through research, MSF has also shown that empowering nurses can also help expand patient access to care. In this collection, we highlight some of the evidence gathered on nurse-led care models at MSF projects, including through strategies that strengthen nurses through innovative training approaches and bedside tools.

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TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.
Expanding access to lifesaving new TB tools

Expanding access to lifesaving new TB tools
Mini-Lab—MSF's simplified bacteriology laboratory for low-resource settings

Mini-Lab—MSF's simplified bacteriology laboratory for low-res...
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Many settings with a high burden of drug-resistant tuberculosis (DR-TB) lack access to advanced diagnostics and to groundbreaking new treatments. The Collection linked below spotlights work by MSF and collaborators to analyze barriers, identify gaps, and accelerate the roll-out of these tools to people whose lives hang in the balance. Several reports examine price, regulatory, and patent obstacles that persist despite considerable public investment into developing many of these tools. Other authors examine critical remaining weaknesses in care pathways—especially in screening and diagnosis, and particularly in children. Several studies describe new strategies that could be part of the solution, from a pilot program in Tajikisttan that trains family caregivers to treat children with DR-TB at home, to a person-centered care model adapted to a conflict zone in Afghanistan. Lastly, initial findings demonstrate that pregnant women—another vulnerable population—can be effectively treated for DR- and multidrug-resistant TB, improving maternal outcomes without harming neonates.
Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. One key limitation in most of these settings is a lack of clinical bacteriology laboratory capacity, which leaves medical providers without ways to accurately diagnose patient infections and to tailor antibiotic treatment accordingly. To help fill this critical gap, MSF and partners have developed the Mini-Lab—a small-scale, standalone lab that is easy to transport, set up and operate by staff after only a short training. Its six modules are stocked with everything needed to diagnose common bloodstream and urinary tract infections and to perform antibiotic sensitivity testing using methods adapted to extremely hot climates and remote settings. With Mini-Lab now being rolled out to selected MSF projects, here we highlight the background to its development and some of the research behind the bacteriological tests it incorporates.
Journal Article
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Research

Nurse-led initiation of hepatitis C care in rural Cambodia

O’Keefe D, Samley K, Bunreth V, Marquardt T, Bobi SE,  et al.
2023-04-01 • Bulletin of the World Health Organization
2023-04-01 • Bulletin of the World Health Organization
OBJECTIVE
To determine whether a nurse-led model of care for patients with hepatitis C virus (HCV) infections can provide safe and effective diagnosis and treatment in a resource-poo...
Conference Material
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Video

Communities of Practice to improve knowledge & teamwork

Deplecker E, Prak S
2022-12-01 • MSF Paediatric Days 2022
2022-12-01 • MSF Paediatric Days 2022
Conference Material
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Video

KidzMed Project: the why and how of pill swallowing

Lim ES
2022-12-01 • MSF Paediatric Days 2022
2022-12-01 • MSF Paediatric Days 2022
Conference Material
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Video

Migration and refuge: Necessary topics for nursing teaching in COVID-19 times of migration

Yoshie Matsue R
2022-11-30 • MSF Scientific Days Latin America 2022
2022-11-30 • MSF Scientific Days Latin America 2022
Conference Material
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Poster

Impact of low-dose high frequency simulation training and mentioring delivered via digital platform on key midwifery skills among midwives in Afghanistan

Sethi S, Shrestha U, Aradhya R
2022-11-30 • MSF Paediatric Days 2022
2022-11-30 • MSF Paediatric Days 2022
Conference Material
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Video

"Le wi go ple ple": the importance of play in a humanitarian paediatric context

Haciomeroglu K
2022-11-30 • MSF Paediatric Days 2022
2022-11-30 • MSF Paediatric Days 2022
Conference Material
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Video

The Covid-19 nurse aide programme in southern Africa: improving provision of basic patient care on Covid-19 wards

Amrani M, Tullet R, Sandler B, Duarte N, Mutubuki H,  et al.
2022-06-10 • MSF Scientific Days International 2022
2022-06-10 • MSF Scientific Days International 2022
Journal Article
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Research

Decentralised hepatitis C testing and treatment in rural Cambodia: evaluation of a simplified service model integrated in an existing public health system

Zhang M, O'Keefe D, Craig J, Samley K, Bunreth V,  et al.
2021-03-19 • Lancet Gastroenterology and Hepatology
2021-03-19 • Lancet Gastroenterology and Hepatology
BACKGROUND
Direct-acting antiviral treatment for hepatitis C virus (HCV) has provided the opportunity for simplified models of care delivered in decentralised settings by non-special...
Journal Article
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Research

Setting up a nurse-led model of care for management of hypertension and diabetes mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study

Frieden M, Zamba B, Mukumbi N, Mafaune PT, Makumbe B,  et al.
2020-06-01 • BMC Health Services Research
2020-06-01 • BMC Health Services Research
BACKGROUND
In the light of the increasing burden of non-communicable diseases (NCDs) on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, contex...
Journal Article
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Research

Clinical mentorship of nurse initiated antiretroviral therapy in Khayelitsha, South Africa: a quality of care assessment

Green A, De Azevedo V, Patten GE, Davies MA, Ibeto M,  et al.
2014-06-02 • PLOS One
2014-06-02 • PLOS One
To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of...
Journal Article
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Research

Reliability and accuracy of the South African Triage Scale when used by nurses in the emergency department of Timergara Hospital, Pakistan

Dalwai MK, Twomey M, Maikere J, Said S, Wakeel M,  et al.
2014-03-26 • South African Medical Journal
2014-03-26 • South African Medical Journal
Background. Triage is one of the core requirements for the provision of effective emergency care and has been shown to reduce patient mortality. However, in low- and middle-income countr...
Journal Article
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Short Report

Antiretroviral treatment outcomes from a nurse-driven, community-supported HIV/AIDS treatment programme in rural Lesotho: observational cohort assessment at two years

Cohen RM, Lynch S, Bygrave H, Eggers E, Vlahakis N,  et al.
2009-10-08 • Journal of the International AIDS Society
2009-10-08 • Journal of the International AIDS Society
ABSTRACT: INTRODUCTION: Lesotho has the third highest HIV prevalence in the world (an adult prevalence of 23.2%). Despite a lack of resources for health, the country has implemented stat...