Since 2013 we have established a variety of projects both directly focusing on acute and critical care and on using expertise developed through this speciality to the enhancement of other specialist community based health priorities. Our research is frontline, pragmatic and focused on improving, information availability, to build capacity for locally driven quality improvement and service provision interventions.
We collaborate with a variety of disciplines including clinical, health informatics, technology, epidemiology, anthropology, improvement science to find innovative ways to help meet our common goals.
Please find a brief summary of the current opportunities for health care related researchers who are wishing to develop hands on experience, whilst directly contributing to the partnerships established with clinicians, academic institutions and the public in resource limited settings.
Acute and Critical care
The main focus of our work focuses on improving recognition and management of acutely unwell patients, and their journey through acute and critical care. These projects extend into surgery and acute medicine, the impact of infectious diseases including dengue, non- communicable diseases including heart disease and renal disease and on patients quality of life following critical care.
We have opportunities for development of research, data acquisition, surveillance, quality improvement and public engagement in the following areas,
● Acute and Critical care
● Perioperative medicine
●Critical care risk stratification and prognostic modelling
● Service provision and planning
● Patient experience and public engagement
● Quality of life and quality of recovery
● Emergency obstetric care
● Sepsis and complications following major general and vascular surgery
● Clinical decision making and team performance
● Health informatics
● Mobile technology and user experience
Examples of current research questions and projects;
● What is the feasibility of applying early warning systems to detect deteriorating patients in a tertiary obstetric LIC setting?
● What is the incidence of post op complications (infection, hemorrhage) and the impact on quality of life and recovery? An evaluation of delivery of care and outcomes for elective surgical patients in LMICs.
● Can risk stratification tools developed for high risk surgical patients in HIC’s (SORT) discriminate at risk patients in LMICs?
● What is the burden of symptoms for patients on renal dialysis in a LMIC?
● What is the ethnography of decision making in the clinical team in acutely unwell patients in different level hospitals in a LMIC?
● How can clinician led co-design improve adoption of electronic platforms in clinical practice?
● Is patient reported information using mobile technology able to enhance recognition and management of acute illness?
● What is the feasibility of using mobile technology to record vital signs in a LIC setting?
● Can implementation of an adapted electronic platform improve management processes around the care of acutely ill patients in LMIC hospitals?
● What are the barriers and enablers to implementation of an electronic surveillance platform in a LMIC?
● Can implementation of an electronic surveillance platform inform spatiotemporal changes in febrile disease epidemiology?
Non- communicable disease and community based projects
Our active community and hospital based projects in working with patients with renal disease nationally provide opportunities for research in,
● The role of registries in service provision and health improvement
● Chronic kidney disease of unknown origin
● Dialysis and renal transplantation
● Quality of life for patients undergoing renal replacement therapy.
Our community based Mental health collaboration with the northern province is a pioneering programme using mobile technology to support community workers caring for communities with limited access to mental health services. Opportunities for research in:
● Non -communicable diseases and mental health
● Social and economic influences on health and well being
In collaboration with the Rabies prevention unit we work to improve information regarding rabies incidence and patients access to and completion of post exposure treatment.
Potential students wishing to participate in our work should have some experience of work at graduate level in their field, and preferably have experience of working or living in resource limited settings. A good level of spoken English and the ability to write in english for academic publication is required.NICST can offer practical support with daya to day field work, data analysis and project design. Students will however need to have academic supervision and oversight from their host institution. As a charity we can offer our resources for research and the network of opportunities freely, however travel and accommodation costs would need to be covered by students or host institutions. We do however have links for grant and small funding streams. Please ask for further details.
The opportunities described come from a unique partnership developed through a community of collaborative research and practice. These opportunities are open to all who share a like minded approach to partnering research, clinicians and the patients to the improvement of healthcare internationally.
We hope you are inspired by the opportunities we create and find synergy in the shared goal of improving healthcare.
In addition to academic research opportunities, NICST coordinates and develops a variety of practical, simulation based training and education programmes for clinical teams and the public. We are happy to provide more information on request.
The NICST team includes postdoctoral researchers, PhD students, MSc graduates and frontline clinicians. We are fortunate to have the expertise of international researchers for academic guidance.
For more information please contact the team or see our website www.nicst.com
First visit from the UCL perioperative medicine collaborative.
Just a few months after we first met in London as a team to discuss global surgery, I had the opportunity to visit NICST in Sri Lanka where I was hosted by Abi Beane, (Nurse researcher, Mahidol Oxford Research Unit and PhD candidate AMC) and the NICST team. I was excited about the prospect of meeting the team behind the great work done at NICST and hopeful of the opportunities to learn, network and collaborate through future development of partnerships between CAPOM and NICST. Essentially a fact-finding opportunity with the added benefits of observing/ taking part in the simulation courses being run while I was there.
Day 1 – Wed 16th August 2017
I was welcomed in to observe the continued training and development process for a trauma simulation course run by pre-interns for senior doctors. I then sat in on and took part in debriefs/troubleshooting. Having a trauma anaesthesia background and working clinically as a senior member of a trauma team in the past, I was able to help build confidence in the observed work simply by encouraging, drawing parallels and providing a different perspective. I took photos and video footage to later share. I also encouraged development and feedback amongst the interns I met with a positive response.
At the NICST office, I met Chaturani, the programme coordinator, who took me through the NICST website explaining the different projects. I met Dr Rasika, a newly qualified doctor who is working with NICST for his final internship. His work focuses on daily data collection and stakeholder engagement for the surgical registry in Sri Lanka. Established in 2015 in partnership with Professor Anuja Abayadeera and the College of Surgeons, Sri Lanka. This registry, live in 3 hospitals, and with over 1000 patients, helps provide real-time information on the quality of care and quality of recovery for patients undergoing major surgery www.nicst.com
Day 2 – Thursday 17th August 2017
An established acute skills course was held today and I joined the trainers to sit in on and get involved with the end of course debrief. Training is a major focus of the NICST project- using practical, clinically-focused training, informed by the frontline research to build knowledge, skills and capacity for QI with frontline teams.