A clinical guidance tool to improve the care of children hospitalized with severe pneumonia in Lusaka, Zambia View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-12

AUTHORS

Catherine G. Sutcliffe, Donald M. Thea, Philip Seidenberg, James Chipeta, Lawrence Mwananyanda, Somwe Wa Somwe, Julie Duncan, Magdalene Mwale, Justin Mulindwa, Musaku Mwenechenya, Rasa Izadnegahdar, William J. Moss

ABSTRACT

BACKGROUND: Pneumonia is the leading infectious cause of death among children, with approximately half of deaths attributable to pneumonia occurring in limited health resource settings of sub-Saharan Africa. Clinical guidance tools and checklists have been used to improve health outcomes and standardize care. This study was conducted to evaluate the impact of a clinical guidance tool designed to improve outcomes for children hospitalized with severe pneumonia in Zambia. METHODS: This study was conducted at University Teaching Hospital in Lusaka, Zambia from October 10, 2011 to March 21, 2014 among children 1 month to 5 years of age with severe pneumonia. In March 2013, a clinical guidance tool was implemented to standardize and improve care. In-hospital mortality pre-and post-implementation was compared. RESULTS: Four hundred forty-three children were enrolled in the pre-intervention period and 250 in the post-intervention period. Overall, 18.2 % of children died during hospitalization, with 44 % of deaths occurring within the first 24 h after admission. Mortality was associated with HIV infection status, pneumonia severity, and weight-for-height z-score. Despite improving and standardizing the care received, the clinical guidance tool did not significantly reduce mortality (relative risk: 0.89; 95 % CI: 0.65, 1.23). The tool appeared to be more effective among HIV-exposed but uninfected children and children younger than 6 months of age. CONCLUSIONS: Simple tools are needed to ensure that children hospitalized with pneumonia receive the best possible care in accordance with recommended guidelines. The clinical guidance tool was well-accepted and easy to use and succeeded in standardizing and improving care. Further research is needed to determine if similar interventions can improve treatment outcomes and should be implemented on a larger scale. More... »

PAGES

136

References to SciGraph publications

  • 2013-02. Review article: Perioperative checklist methodologies in JOURNAL CANADIEN D'ANESTHÉSIE
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    URI

    http://scigraph.springernature.com/pub.10.1186/s12887-016-0665-z

    DOI

    http://dx.doi.org/10.1186/s12887-016-0665-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1038278737

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27542355


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        "description": "BACKGROUND: Pneumonia is the leading infectious cause of death among children, with approximately half of deaths attributable to pneumonia occurring in limited health resource settings of sub-Saharan Africa. Clinical guidance tools and checklists have been used to improve health outcomes and standardize care. This study was conducted to evaluate the impact of a clinical guidance tool designed to improve outcomes for children hospitalized with severe pneumonia in Zambia.\nMETHODS: This study was conducted at University Teaching Hospital in Lusaka, Zambia from October 10, 2011 to March 21, 2014 among children 1\u00a0month to 5\u00a0years of age with severe pneumonia. In March 2013, a clinical guidance tool was implemented to standardize and improve care. In-hospital mortality pre-and post-implementation was compared.\nRESULTS: Four hundred forty-three children were enrolled in the pre-intervention period and 250 in the post-intervention period. Overall, 18.2\u00a0% of children died during hospitalization, with 44\u00a0% of deaths occurring within the first 24\u00a0h after admission. Mortality was associated with HIV infection status, pneumonia severity, and weight-for-height z-score. Despite improving and standardizing the care received, the clinical guidance tool did not significantly reduce mortality (relative risk: 0.89; 95\u00a0% CI: 0.65, 1.23). The tool appeared to be more effective among HIV-exposed but uninfected children and children younger than 6\u00a0months of age.\nCONCLUSIONS: Simple tools are needed to ensure that children hospitalized with pneumonia receive the best possible care in accordance with recommended guidelines. The clinical guidance tool was well-accepted and easy to use and succeeded in standardizing and improving care. Further research is needed to determine if similar interventions can improve treatment outcomes and should be implemented on a larger scale.", 
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    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/s12887-016-0665-z'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/s12887-016-0665-z'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/s12887-016-0665-z'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/s12887-016-0665-z'


     

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