A 2-Phase Survey to Assess a Facility's Readiness for Pediatric Essential Emergency and Critical Care in Resource-Limited Settings: A Literature Review and Survey Development.
Journal
Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560
Informations de publication
Date de publication:
01 Oct 2022
01 Oct 2022
Historique:
pubmed:
19
8
2022
medline:
4
10
2022
entrez:
18
8
2022
Statut:
ppublish
Résumé
Infectious diseases, including pneumonia, malaria, and diarrheal diseases, are the leading causes of death in children younger than 5 years worldwide. The vast majority of these deaths occur in resource-limited settings where there is significant variation in the availability and type of human, physical, and infrastructural resources. The ability to identity gaps in healthcare systems that may hinder their ability to deliver care is an important step to determining specific interventions for quality improvement. Our study objective was to develop a comprehensive, digital, open-access health facility survey to assess facility readiness to provide pediatric critical care in resource-limited settings (eg, low- and lower middle-income countries). A literature review of existing facility assessment tools and global guidelines was conducted to generate a database of survey questions. These were then mapped to one of the following 8 domains: hospital statistics, services offered, operational flow, facility infrastructure, staff and training, medicines and equipment, diagnostic capacity, and quality of clinical care. A 2-phase survey was developed and an iterative review process of the survey was undertaken with 12 experts based in low- and middle-income countries. This was built into the REDCap Mobile Application for electronic data capture. The literature review process yielded 7 facility assessment tools and 7 global guidelines for inclusion. After the iterative review process, the final survey consisted of 11 sections with 457 unique questions in the first phase, "environmental scan," focusing on the infrastructure, availability, and functionality of resources, and 3 sections with 131 unique questions in the second phase, "observation scan," focusing on the level of clinical competency. A comprehensive 2-phase survey was created to evaluate facility readiness for pediatric critical care. Results will assist hospital administrators and policymakers to determine priority areas for quality improvement, enabling them to implement a Plan-Do-Study-Act cycle to improve care for the critically ill child.
Identifiants
pubmed: 35981329
doi: 10.1097/PEC.0000000000002826
pii: 00006565-202210000-00011
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
532-539Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors declare no conflict of interest.
Références
World Health Organization. Children: improving survival and well-being. 2020 Sep. Available at: https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality . Accessed November 25, 2020.
United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), ‘Levels & trends in child mortality: report 2019, estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation, United Nations Children's Fund, New York, 2019.
Liu L, Johnson HL, Cousens S, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet . 2012;379:2151–2161.
Weiss SL, Peters MJ, Alhazzani W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Pediatr Crit Care Med . 2020;21:e52–e106.
Nickerson JW, Adams O, Attaran A, et al. Monitoring the ability to deliver care in low- and middle-income countries: a systematic review of health facility assessment tools. Health Policy Plan . 2015;30:675–686.
Campbell H, Duke T, Weber M, et al. Global initiatives for improving hospital care for children: state of the art and future prospects. Pediatrics . 2008;121:e984–e992.
English M, Ntoburi S, Wagai J, et al. An intervention to improve paediatric and newborn care in Kenyan district hospitals: understanding the context. Implement Sci . 2009;4:1–8.
Rahman AE, Iqbal A, Hoque DME, et al. Managing neonatal and early childhood syndromic sepsis in sub-district hospitals in resource poor settings: improvement in quality of care through introduction of a package of interventions in rural Bangladesh. PLoS One . 2017;12:1–19.
Aluvaala J, Nyamai R, Were F, et al. Assessment of neonatal care in clinical training facilities in Kenya. Arch Dis Child . 2015;100:42–47.
Duke T, Keshishiyan E, Kuttumuratova A, et al. Quality of hospital care for children in Kazakhstan, Republic of Moldova, and Russia: systematic observational assessment. Lancet . 2006;367:919–925.
English M, Esamai PF, Wasunna PA, et al. Delivery of paediatric care at the first-referral level in Kenya. Lancet . 2004;364:1622–1629.
Simoes EAF, Peterson S, Gamatie Y, et al. Management of severely ill children at first-level health facilities in sub-Saharan Africa when referral is difficult. Bull World Health Organ . 2003;81:522–531.
Donabedian A. The quality of care. How can it be assessed? JAMA . 1988;260:1743–1748.
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform . 2009 Apr;42:377–381.
Vanderbilt University. REDCAP MOBILE DEVICE APPLICATIONS—REDCap. Available at: https://projectredcap.org/software/mobile-app/ . Accessed March 15, 2021.
Kissoon N, Fung J, Hwang B, et al. Environmental scan tools for data collection to determine readiness to treat sepsis (dataset) ~ Pediatric Sepsis Data CoLab Environmental Scan. Scholars Portal Dataverse; 2020. Available at: https://doi.org/10.5683/SP2/ZM8FN8 . Accessed March 15, 2021.
Betjeman TJ, Soghoian SE, Foran MP. mHealth in Sub-Saharan Africa. Int J Telemed Appl . 2013;2013:482324.
Raihana S, Dunsmuir D, Huda T, et al. Development and internal validation of a predictive model including pulse oximetry for hospitalization of under-five children in Bangladesh. PLoS One . 2015;10:1–15.
Pop-Eleches C, Thirumurthy H, Habyarimana JP, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS . 2011;25:825–834.
Nolan T, Angos P, Cunha AJ, et al. Quality of hospital care for seriously ill children in less-developed countries. Lancet . 2001;357:106–110.
World Health Organization. WHO model list of essential medicines for children. 2017 Mar. Available at: https://www.who.int/publications/i/item/EMLc-6 . Accessed August 20, 2017.
World Health Organization. Service Availability and Readiness Assessment (SARA): an annual monitoring system for service delivery. 2015 Jul. Available at: https://www.who.int/healthinfo/systems/sara_reference_manual/en/ . Accessed August 20, 2017.
World Health Organization. Improving measurement of the quality of maternal, newborn and child care in health facilities. 2014. Available at: https://www.who.int/maternal_child_adolescent/documents/measuring-care-quality/en/ . Accessed August 20, 2017.
World Health Organization. Service availability mapping. 2004. Available at: https://www.who.int/healthinfo/systems/samintro/en/ . Accessed August 20, 2017.
World Health Organization. Health facility survey. 2003. Available at: https://www.who.int/maternal_child_adolescent/documents/9241545860/en/ . Accessed August 20, 2017.
The DHS Program. Service provision assessment. 2012. Available at: https://dhsprogram.com/methodology/Survey-Types/SPA.cfm . Accessed August 20, 2017.
Measure evaluation. Guidance for selecting and using core indicators for cross-country comparisons of health facility readiness to provide services. 2007. Available at: https://www.measureevaluation.org/resources/publications/wp-07-97 . Accessed August 20, 2017.
Gabrysch S, Civitelli G, Edmond KM, et al. New signal functions to measure the ability of health facilities to provide routine and emergency newborn care. PLoS Med . 2012;9:e1001340.
Weiss SL, Fitzgerald JC, Pappachan J, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med . 2015;191:1147–1157.
Tan B, Wong JJ-M, Sultana R, et al. Global case-fatality rates in pediatric severe Sepsis and septic shock: a systematic review and meta-analysis. JAMA Pediatr . 2019;173:352–361.
Bataar O, Lundeg G, Tsenddorj G, et al. Nationwide survey on resource availability for implementing current sepsis guidelines in Mongolia. Bull World Health Organ . 2010;88:839–846.
Ames SG, Davis BS, Marin JR, et al. Emergency department pediatric readiness and mortality in critically ill children. Pediatrics . 2019;144:e20190568.
Dünser MW, Baelani I, Ganbold L. A review and analysis of intensive care medicine in the least developed countries. Crit Care Med . 2006;34:1234–1242.
Haniffa R, De Silva AP, Iddagoda S, et al. A cross-sectional survey of critical care services in Sri Lanka: a lower middle–income country. J Crit Care . 2014;29:764–768.
Remick K, Gausche-Hill M, Joseph MM, et al; American Academy of Pediatrics Committee on Pediatric Emergency Medicine and Section on Surgery; American College of Emergency Physicians Pediatric Emergency Medicine Committee; Emergency Nurses Association Pediatric Committee. Pediatric readiness in the emergency department. Pediatrics . 2018;142:e20182459.
Balmaks R, Whitfill TM, Ziemele B, et al. Pediatric readiness in the emergency department and its association with patient outcomes in critical care: a prospective cohort study. Pediatr Crit Care Med . 2020;21:E213–E220.
Baelani I, Jochberger S, Laimer T, et al. Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers. Crit Care . 2011;15:R10.
Molyneux E, Ahmad S, Robertson A. Improved triage and emergency care for children reduces inpatient mortality in a resource-constrained setting. Bull World Health Organ . 2006;84:314–319.
Ralston ME, Day LT, Slusher TM, et al. Global paediatric advanced life support: improving child survival in limited-resource settings. Lancet . 2013;381:256–265.
GSMA. The mobile economy Sub-Saharan Africa 2019. GSMA . 2019. Available at: https://www.gsma.com/subsaharanafrica/resources/the-mobile-economy-sub-saharan-africa-2019 . Accessed September 28, 2017.
GSMA. The state of mobile internet connectivity. 2019. Available at: https://www.gsma.com/mobilefordevelopment/resources/the-state-of-mobile-internet-connectivity-report-2019/ . Accessed September 28, 2017.
Amoakoh HB, Klipstein-Grobusch K, Grobbee DE, et al. Using mobile health to support clinical decision-making to improve maternal and neonatal health outcomes in Ghana: insights of frontline health worker information needs. JMIR mHealth uHealth . 2019;7:e12879.
Case T, Morrison C, Vuylsteke A. The clinical application of mobile technology to disaster medicine. Prehosp Disaster Med . 2012;27:473–480.
Ngabo F, Nguimfack J, Nwaigwe F, et al. Designing and implementing an innovative SMS-based alert system (RapidSMS-MCH) to monitor pregnancy and reduce maternal and child deaths in Rwanda. Pan Afr Med J . 2012;13:31.
Lemay NV, Sullivan T, Jumbe B, et al. Reaching remote health workers in Malawi: baseline assessment of a pilot mhealth intervention. J Health Commun . 2012;17(suppl 1):105–117.
BC Children's Hospital Research Institute. Pediatric Sepsis Data CoLab. Available at: https://www.bcchr.ca/pediatric-sepsis-data-colab . Accessed June 12, 2020.