By Maha Aljuaid, RN, BSN, MSN, acute-care CNS, nurse specialist, Neurocritical Care Unit, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; and Faisal Al-Suwaidan MBBS, SBN, SFCCM, consultant of adult neurology, critical care medicine, neurological and neurosurgical critical care, chairman Neurocritical Care Department, National Neuroscience Institute, King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia
Medicine in Saudi Arabia has taken giant steps in the last few decades toward modern medicine in all specialties, and it is still growing day after day. Critical care medicine is, by far, one of the fastest growing nationwide specialties. This is reflected in huge investment in specialized training to overcome the unmet needs and shortage of qualified critical care clinicians.
Neurocritical care medicine was born as a chapter in 2010 under the Saudi Critical Care Society (SCCS). A small group of enthusiastic Saudi physicians joined together to promote neurocritical care medicine through training, education and presenting the first Saudi Neurocritical Care Meeting that was hosted for five days in 2012 at Dammam city in the eastern provence of Saudi Arabia.
The practice of neurocritical care as it known today has evolved through different maturity stages from neurocritical care consultation services seeing cases on demand to a cohort of NCCU wards admitting neuro patients and managing them utilizing protocol-based practice to closed neurocritical care units led by certified neuro-intensivists and multidisciplinary critical care clinicians trained to provide high-quality care to full spectrum of neurological/neurosurgical pathologies and disorders.
The first neurocritical care unit was established in 2009 with a capacity of eight beds and providing 24/7 advance neuro-monitoring modalities to all types of neurological and neurosurgical cases. The unit profile included status epilepticus requiring continuous EEG monitoring, compromised central nervous system infection, neurosurgical patients with ICP monitoring, acute cerebral ischemia and post-interventional neuro-radiological procedures.
The establishment of advanced neurocritical care units has expanded rapidly nationwide into all major medical cities and healthcare institutes in Saudi Arabia.
Neurocritical Care Training in Saudi Arabia
The Saudi Commission for Health Specialties (SCFHS) is the national body for certification and registration for all healthcare providers. A remarkable growth is noticed both in quality and quantity for postgraduate training through structured residency and fellowship programs with standardized curriculum and examination processes. Many programs have adapted neurocritical care rotations, such as the Saudi Board of Neurology, Saudi Board of Neurosurgery, Saudi Stroke Fellowship and Saudi Critical Care Fellowship. This reflects the advancement in neurocritical care in the Kingdom.
Nurses have faster and earlier engagement in a structured training and education programs in neurocritical care. Multiple training programs for nurses have been established in advanced medical cities across the nation, such as neuroscience and specialized stroke programs.
Neurocritical care residency program for Saudi nurses was established in 2012 at King Abdulaziz, providing them with advanced skills and knowledge to provide quality care for neurocritical patients. Simulation-based education was integrated in 2010 to train newly hired nurses to neurocritical care, and aimed to improve safety and quality of care. Nurses who underwent simulation-based orientation had reported that use of simulation enhances their knowledge and skills, and they felt that simulation activities are engaging and built more confidence.
Multidisciplinary training is a magnificent platform for the advancement of neurocritical care in the Saudi Arabia. Many critical care departments within academic teaching hospitals have recognized the importance of multidisciplinary simulation and have incorporated simulation into their training programs for medical residents, nurses and other allied health professionals.
Future of Neurocritical Care in Saudi Arabia
The Saudi healthcare system is going through a transformational period under the new country vision of 2030. Healthcare sectors are determined to optimize utilization of the available advanced healthcare resources, and provide better training for healthcare professionals in the management of chronic diseases and specialty care services, such as neurocritical care, as well as increase investments in clinical research.