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These abstracts represent the nursing poster award abstracts from the 2022 18th Emirates Critical Care Conference. Topics include the effectiveness of prehabilitation on improving the emotional recovery of patients undergoing open heart surgeries, shifting metaphysical paradigms in nursing, experience and the challenge of emergency and critical care nurses in identifying and managing arrhythmia at the Emergency Department of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, and critical care nurses’ knowledge of correct administration line types for common intravenous medications.

Introduction: Although morbidity and mortality rates are declining for acute coronary syndrome (ACS) in most high-income countries, it is rising at an alarming pace for low to middle-income countries (LMICs), largely due to pre-hospital treatment delays. Purpose: This systematic review was conducted to determine the mean length of time from symptom onset to treatment in LMICs and the sociodemographic, clinical, and health system characteristics that contribute to treatment delays. Methods: A comprehensive review of the English literature was conducted between January 1990 through May 2020 using predefined criteria. Time to treatment was defined from ACS symptom onset to first medical contact and then further dichotomized as less than (early) or greater than 12-hours (late) treatment. Twenty-nine peer-reviewed studies, which comprised 29,731 subjects with ACS symptoms residing in 14 LMICs. Sample sizes in the studies ranged from 50 to 20,937. Age ranged from 28-72 years and the majority were males. The Newcastle-Ottawa Assessment Scale was utilized to measure study quality. Results: The mean time from symptom onset to first medical contact was 12.7 hours, ranging from10-minutes to 96 hours. Being older age, female gender, illiterate, rural residence, having atypical chest pain and lack of ACS symptom knowledge were associated with longer delays. Those directly admitted to an emergency department with the capacity to provide coronary interventions received earlier treatment. Community facilities where ECG machines were available had lower prehospital delay time for referral to reperfusion therapy facilities. Lack of emergency medical systems, poor communication between the community and interventional facilities were also major contributors to ACS treatment delays. Conclusions: Pre-hospital delay time remains an important contributor to poorer clinical outcomes and higher mortality in LMICs. Country-wide referral plans are urgently needed to ensure timely transfer of patients from non-cardiac centers to interventional facilities. Health education through the different media outlets will raise awareness of ACS risk factors, accompanying signs and symptoms as well as the need to seek early treatment to improve clinical outcomes.

Background: Acute coronary syndrome (ACS) morbidity and mortality is increasing in low to middle-income countries (LMICs) such as Ethiopia. The shift in resources from managing communicable diseases to chronic conditions has brought about formidable health challenges. Purpose: The purpose of this study was to examine the knowledge, attitudes, beliefs among diagnosed ACS patients admitted to one of 3 emergency departments (ED) in Ethiopia. Methods: Sociodemographic (age, gender, education, employment status), clinical (comorbidities) data were collected. Knowledge, attitudes, beliefs about ACS were measured using the modified ACS Response Index questionnaire, with cut-off scores greater than 70% indicating adequate knowledge, attitudes and beliefs about ACS. Data were analyzed using chi-square test and stepwise multivariable logistic regression. Results: Participant’s (N=330) mean age was 57.9 ± 14.1, majority male (n= 219, 66.36%). Over half (N=183, 55.4 %) demonstrated adequate knowledge, attitudes (n=178, 53.9%), and beliefs (n=177, 53.64%) about ACS symptoms. Chest discomfort (n= 274, 83%), fatigue (n=267, 80.9%), chest pain (n=266, 80.6%) were recognized as ACS symptoms. Jaw pain (n=101, 30%) neck pain (n=146 ,44.2%), nausea (n=159,48%), were less recognized. Only (n=104, 31%) of participants indicated they would seek help and only (n=116, 35.1%) would use emergency medical services (EMS). Patients who were Conclusions: Despite receiving treatment for ACS in an ED, roughly half of the participants had adequate knowledge of symptoms and less than 40% would utilize EMS. Improving EMS and developing educational awareness in Ethiopia are essential for improving symptom identification, appropriate responses and outcomes related to ACS.

In 2015, Ethiopia's first PhD in nursing program was established in collaboration between the Addis Ababa University (AAU) and Emory University Schools of Nursing. Eleven students have entered the program since its inception, six have successfully defended their proposals, one has graduated, and two have received Fogarty Global Health Fellowships. This paper describes the evolution of this international partnership and the innovative processes and mechanisms involved in program implementation; the authors address the description of the program, central implementation challenges, notable outcomes, and student achievements. One key implementation challenge has been that, although nursing is one of the largest healthcare workforces in Ethiopia, nurses remain underutilized and undervalued in the workplace. This treatment is due, in part, to limited professional regulations, leading some of the PhD students to apply their leadership skills to advocate for national practice reform. According to students, the PhD program has been a means not only to improve nursing research capacity and education in Ethiopia, but also to generate the regulations necessary for graduates to practice according to their degree. While the opportunity to generate knowledge is vitally important, students also value the chance to transform the profession of nursing.