Introducing the IITT to Kiribati July 20

Kiribati

Introducing the IITT to Kiribati (July 2023)

In July 2023, we were proud to work with the dynamic ED team at Tungaru Central Hospital (TCH) and the smaller Betio hospital to introduce the Interagency Integrated Triage Tool (IITT), a 3-tier triage system purpose-designed for the kind of high acuity, low resource environment found in Kiribati.

Having both worked as part of a larger team to introduce and support the IITT at Angau Memorial Provincial Hospital in Lae, PNG, we were a little anxious about the short turnaround to bring the system to Tarawa. However, we need not have worried; the enthusiasm and dedication of the staff meant that uptake went smoothly, including colour coding both Emergency Departments with rolls of tape brought in from Australia.

Training included the use of the MSF training platform TEMBO, which had its challenges with the slow local internet speeds but opened up the possibility of other free educational opportunities, which many of the staff appreciated.

Midwives from TCH also joined the training sessions, here Midwife Teaoi and OB SNO Keeang navigate the TEMBO site.

Hard copies of the triage categories supported the online learning process

Using the floor plan of TCH ED on the computer, and later as a series of movable virtual beds and patients up on the wall, Angie encouraged the group to think about patient flow considerations and where the best place for each presentation might be.

Lead by Nurse Unit Manager, Tareaua, the team decided where to apply the colour coded tape for each acuity area.

After a morning on hands and knees, everyone was very happy with the result!

Colour-coded triage boxes allowed Dr Tabutoa to see which patients needed his attention first quickly.

Staff at Betio came up with a significant rearrangement of their ED space to better manage acuity and patient flow

The staff allocation board, clearly outlining a team leader for each shift, role allocation by acuity area and important shift tasks such as equipment checking, were embraced by the ED and Overflow areas and attracted interest from other areas of the hospital also.

Staff allocating roles for the afternoon shift.

SCIP and IITT ToT

The existing group of trainers in Tarawa was bolstered by another two previous PENT graduates to support the excellent ongoing work they have been doing running SCIP courses for new graduates, nurses heading to the Outer Islands and nurse aides.

Nikoatetota (end of table) and Maatia (second right), joined the existing group of trainers and participated in a day of SCIP for nurse aides, OPD and ward staff.

SCIP trainers; Taanini, Maatia, Teretia, Meria, Arourenga, Nikoatetoka & Oteniera.

The beautiful gifts of IITT Tibuta are a wonderful reminder of the dedication and enthusiasm this excellent group of clinicians have brought to the process of positive change in their workplace.

Kiribati

Introducing the IITT to Kiribati (July 2023)

SCIP and IITT ToT

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