On 13.04.2018 Kyrgyz ESO-EAST team made it possible to organize a key-event: the conference at National Hospital of Ministry of Health with the participation of Ministry of Health representatives, WHO regional office in Kyrgyzstan and doctors of neurological departments of National Hospital of Kyrgyzstan. National Hospital is the flagman of medical services in Kyrgyzstan and provides the medical care on the tertiary level for patients from all over the country, admitting according from even remote areas. “ESO-EAST Project Activities in Kyrgyzstan”.

Meeting was opened by Dr. Nurgul Ibraeva, who is the Chief Therapist in Ministry of Health, the main specialist of the department of treatment and preventive care in Ministry of Health. She mentioned, that in 2016, the first assessment of the provision of medical care to patients with stroke and infarction was carried out and the result of this activity was the creation of the “Road Map for acute coronary syndrome and stroke”. “The Roadmap” consists of three stages of rendering medical care to patients: prehospital, hospital and rehabilitative stage and was developed by special working group, consisting of neurologists and cardiologists. Two WHO experts who visited Kyrgyzstan recently made it clear that unified country stroke registry is necessary for correct statistical analysis of the data.

Dr. Dinara Saginbaeva, the Head of National Hospital of Ministry of Health was moderating the meeting.

From ESO-EAST part in Kyrgyzstan Dr. Lutsenko Inna and three young doctors were present: Nazhmudinova Dayana, Sultanova Aishoola and Ismailova Aziza.

Dr. Lutsenko Inna made a presentation, which included several parts, each of which was discussed in details. She spoke about the ESO-EAST project, Angels Initiative Project, RES-Q stroke registry, about the Steering Committee and activities since the launch of the project. The main attention of the meeting was brought to the usage of neurological scales NIHSS and mRS. It was underlined, that scales can simplify the work of physicians and bring the one view of stroke condition and severity. The crucial point of discussion was FeSS-protocol. We shared our experience in FeSS use in 2 departments and informed neurologists, that we have translated the FeSS protocol in Kyrgyz language as well.

The main emphasis of the presentation was made on the RES-Q register, which assesses the quality of stroke treatment. We shared our achievements in RES-Q work, about this register itself, its components, advantage over other registers of cerebral stroke. We displayed the position of Kyrgyzstan in RES-Q usage among other countries and appealed the doctors of National Hospital to join our initiative.

The audience was told about the Angels Initiative site, its main aims and ideas, the training “Train The Trainer” workshop, about its goals and tasks. This presentation raised the topic of improving the quality of care for patients with acute cerebral stroke disorder at four stages: prehospital (at the level of emergency medical care), hospital (optimization of treatment at the clinic level), decision-making for stroke in the most acute phase and a program of skills that the nurse takes in the department of acute stroke.

Dr. Aliyna Altymysheva, WHO Regional Office in Kyrgyzstan Expert, highlighted the necessity of the collaboration with WHO, supporting its initiatives and using the practical help of such experts as Dr.Francesca Pezzella, who have made recently the NIHSS training for doctors in Kyrgyzstan and brings valuable comments to the Roadmap of stroke and acute coronary syndrome.

Vice-head of National Hospital mentioned, that “The Order of Ministry of Health N 300” states that the National Hospital is a methodological center for in-patient institutions across the country. Interventions to the hospital are needed not only in terms of training, but also in equipment. It is necessary to work more actively with colleagues-neurologists, so that everyone is informed”.

At the end of meeting, Dr.Dinara Saginbaeva concluded, that this initiative with implementation of the RES-Q stroke registry in the framework of the ROADMAP is timely. “We should join this initiative, taking into account the statistics of strokes in Kyrgyz Republic. As soon as the ROADMAP is implemented and approved, I think our hospital will be the most active, up to inviting trainers from Angels Initiative in Kyrgyzstan to train our professionals. We have just noticed how many opportunities this project offers. Even we, maybe, National Hospital will become the main training center for the whole republic. Thank you, Dr.Lutsenko and new trainers of Angels Initiative project, let’s implement this initiative step-by-step.”

On July 18, 2018 our team, consisting of Nazhmudinova Dayana, Sultanova Aishoola and Omurbekov Sultanbek under the supervision of Dr.Lutsenko made a NIHSS training the Department of Neurology №3 of the National Hospital and on the July, 20th, Neurology Department 2 was attended. NIHSS scale was presented to the doctors of the department with the help of materials that were provided at the training on the scale of NIHSS by Dr.Francesca Pezella and the hand-outs, provided on Angels Initiative workshop in Wiesbaden. The methods for evaluating every point of the NIHSS scale such as the level of consciousness, the horizontal eye movement, the visual field, the facial palsy, the motor arm and legs, the limb ataxia, the sensory, language, speech, extinction and inattention, which are basics for the NIHSS use in each acute stroke department, were demonstrated. The doctors of the department also were informed about quality monitoring registry RES-Q. Dayana presented her part about the RES-Q implementation in Kyrgyzstan and appealed the doctors to join this initiative. It was decided, that both departments will start step-by-step implementation of NIHSS with the following RES-Q use.

At the end of the training Kyrgyz team shared experience, gained at the training “Train the trainer” at Wiesbaden. We shared the knowledge in the field of improvement of  the stroke care quality in the acute period of stroke considering pre-hospital, hyperacute, decision making and post acute phases. The head of the department invited our team to make this training in further visits to make sure that the doctors of this department correctly performing NIHSS. Also Dr.Kerimkulova added that her department is getting ready to join the RES-Q in September 2018.

 

On behalf of ESO-EAST, Kyrgyzstan,

Lutsenko Inna, Sultanova Aishoola, Nazhmudinova Dayana