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“Universal medical nurse in the context of COVID-19” model implemented in pilot hospitals of Kyrgyzstan with USAID’s support

On March 31, 2021, the U.S. Agency for International Development (USAID) together with the Ministry of Health and Social Development of the KR held a round table to discuss the results of implementing a “Universal Medical Nurse in the Context of COVID-19” model in pilot hospitals of the country.

During the COVID-19 pandemic, medical nurses faced a tremendous workload. Medical nurses had to work in the red zones as well as fulfill routine prescriptions of physicians and were thus unable to effectively monitor patients due to lack of time. Care and hourly observation of patients were not possible due to the enormous workload, however, this is crucial for COVID-19 patients. For this reason, it was decided to implement a “universal medical nurse” model to optimize the performance of nursing professionals and improve the quality of nursing care.

With the support of USAID’S “Local Health System Sustainability” Project, an assessment of the current condition of hospitals was conducted and normative documents developed. The model was launched in test mode in three hospitals: National Hospital, Republican Clinical Infectious Diseases Hospital, and Urban Clinical Hospital №1.

The main aim of the pilot was to establish a patient-oriented work model for nurses and delegate several of the physicians’ functions to them. Workload standards have been revised. From 8 to 12 patients, based on the severity of their condition, were assigned to each universal nurse. Patient-oriented functional duties of a nurse were developed.

After the training and implementation of the “universal medical nurse” model, nurses started to work in accordance with the requirements of standard operating procedures, approved by the MoH KR in August 2020. These were developed with the technical support of a Swiss project on “Reforming medical education” and in compliance with the requirements of infection control and the safety of medical procedures.

Upon implementing a patient’s chart, continuity was established in the work of nurses and physicians. Filling out the chart is very useful for patient management: the chart contains all necessary information for performing dynamic observation and adjusting drug therapy immediately during a round according to the patient’s condition, which greatly saves time for physicians. The present pilot project generated great interest in different health sectors, such as nursing education and professional development, practical work of nurses, particularly in this difficult and hectic period of the COVID-19 pandemic, delegating responsibilities and increasing the role of nurses, geographic imbalance in human resources and motivation of nurses. The event was held in mixed format (offline and online platform) with the participation of more than 180 representatives of the nursing community and educational institutions, practicing nurses from the red zones of health organizations, and development partners.

Following the meeting, it was decided to adopt key recommendations on the further improvement and expansion of the pilot “universal medical nurse” model, on increasing the role and responsibility of nurses, developing regulatory and legal documents on the workload and schedule of nurses in the context of an emergency and, most importantly, creating a mechanism for supporting and encouraging the invaluable work performed by medical nurses in Kyrgyzstan.

Nursing professionals comprise the largest category of healthcare workers (over 33 thsd.) who, together with physicians, provide the population with accessible, affordable and cost-effective medical care.

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USAID’S “Local Health System Sustainability” Project helps to strengthen the work of pilot health organizations. The project works together with different medical establishments to train medical workers in COVID-19 diagnostics and treatment, form and strengthen multidisciplinary teams, improve infection control, create information systems for better epidemiological surveillance, streamline COVID-19 laboratory diagnostics and procure medical and diagnostic equipment.

Since the beginning of the COVID-19 pandemic in the Kyrgyz Republic, USAID provided over USD 5 million through partner organizations, such as Abt Associates, WHO, and the International Federation of Red Cross and Red Crescent Societies. These funds were channeled towards purchasing personal protective equipment, modernizing laboratories to accelerate testing, improving information systems for more precise tracking of the epidemiological situation, as well as training more than 4 thousand medical specialists in COVID-19 clinical treatment. In addition, USAID also supports information campaigns on preventive measures to help bust myths and fight false information about the disease.


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