دورية أكاديمية
Implementation and evaluation of obstetric early warning systems in tertiary care hospitals in Nigeria.
| العنوان: | Implementation and evaluation of obstetric early warning systems in tertiary care hospitals in Nigeria. |
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| المؤلفون: | Umar A; Durham and Tees Valley GP Training Program, Health Education North-East of England, Newcastle, United Kingdom., Ibrahim S; University of Ilorin Teaching Hospital, Ilorin, Nigeria., Liman I; National Hospital Abuja, Abuja, Nigeria., Chama C; Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria., Ijaiya M; University of Ilorin Teaching Hospital, Ilorin, Nigeria., Mathai M; Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom., Ameh C; Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom. |
| المصدر: | PLOS global public health [PLOS Glob Public Health] 2022 Jul 20; Vol. 2 (7), pp. e0000225. Date of Electronic Publication: 2022 Jul 20 (Print Publication: 2022). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 9918283779606676 Publication Model: eCollection Cited Medium: Internet ISSN: 2767-3375 (Electronic) Linking ISSN: 27673375 NLM ISO Abbreviation: PLOS Glob Public Health Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: San Francisco, California : Public Library of Science, [2021]- |
| مستخلص: | Obstetric Early Warning Systems (EWS) use combined clinical observations to predict increased risk of deterioration and alert health workers to institute actions likely to improve outcomes. The objective of this study was to explore the experience of health workers about the implementation of an obstetric EWS and assess its effectiveness as an alternative clinical monitoring method compared to standard practice. This mixed-method study included obstetric admissions (n = 2400) to inpatient wards between 01/08/2018 and 31/03/2019 at three Nigerian tertiary hospitals (1 intervention and two control). Outcomes assessed were the efficiency of monitoring and recording vital signs using the patient monitoring index and speed of post-EWS trigger specialist review. These were evaluated through a review of case notes before and four months after EWS was introduced. Qualitative data was collected to explore healthcare workers' views on EWS' acceptability and usability. EWS was correctly used in 51% (n = 307) of the women in the intervention site. Of these women, 58.6% (n = 180) were predicted to have an increased risk of deterioration, and 38.9% (n = 70) were reviewed within 1 hour. There was a significant improvement in the frequency of vital signs recording in the intervention site: observed/expected frequency improved to 0.91 from 0.57, p<0.005, but not in the control sites. Health workers reported that the EWS helped them cope with work demands while making it easier to detect and manage deteriorating patients. Nurses and doctors reported that the EWS was easy to use and that scores consistently correlated with the clinical picture of patients. Identified challenges included rotation of clinical staff, low staffing numbers and reduced availability of monitoring equipment. The implementation of EWS improved the frequency of patient monitoring, but a larger study will be required to explore the effect on health outcomes. The EWS is a feasible and acceptable tool in low-resource settings with implementation modifications. Trial registration: ISRCTN, ISRCTN15568048. Registration date; 9/09/2020- Retrospectively registered, http://www.isrctn.com/ISRCTN15568048. Competing Interests: The authors declare that they have no competing interests. (Copyright: © 2022 Umar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
| التعليقات: | Erratum in: PLOS Glob Public Health. 2023 Apr 4;3(4):e0001807. (PMID: 37014844) |
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| تواريخ الأحداث: | Date Created: 20230324 Latest Revision: 20230404 |
| رمز التحديث: | 20230404 |
| مُعرف محوري في PubMed: | PMC10022187 |
| DOI: | 10.1371/journal.pgph.0000225 |
| PMID: | 36962704 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2767-3375 |
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| DOI: | 10.1371/journal.pgph.0000225 |