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Magnitude and pattern of improvement in processes of care for hospitalised children with diarrhoea and dehydration in Kenyan hospitals participating in a clinical network
- Source :
- Tropical Medicine & International Health
- Publication Year :
- 2018
- Publisher :
- John Wiley and Sons Inc., 2018.
-
Abstract
- Objective WHO recommends optimisation of available interventions to reduce deaths of under‐five children with diarrhoea and dehydration (DD). Clinical networks may help improve practice across many hospitals but experience with such networks is scarce. We describe magnitude and patterns of changes in processes of care for children with DD over the first 3 years of a clinical network. Methods Observational study involving children aged 2–59 months with DD admitted to 13 hospitals participating in the clinical network. Processes of individual patient care including agreement of assessment, diagnosis and treatment according to WHO guidelines were combined using the composite Paediatric Admission Quality of Care (PAQC) score (range 0–6). Results Data from 7657 children were analysed and improvements in PAQC scores were observed. Predicted mean PAQC score for all the hospitals at enrolment was 59.8% (95% CI: 54.7, 64.9) but showed a wide variation (variance 10.7%, 95% CI: 5.8, 19.6). Overall mean PAQC score increased by 13.8% (95% CI: 8.7–18.9, SD between hospitals: ±8.2) in the first 12 months, with an average 0.9% (95% CI: 0.3–1.5, SD ± 1.0) increase per month and plateaued thereafter, and changes were similar in two groups of hospitals joining the network at different times. Conclusion Adherence to guidelines for children admitted with DD can be improved through participation in a clinical network but improvement is limited, not uniform for all aspects of care and contexts and occurs early. Future research should address these issues.
- Subjects :
- Diarrhea
Male
medicine.medical_specialty
Kenya
déshydratation
Quality Assurance, Health Care
030231 tropical medicine
Psychological intervention
diarrhée
enfants
Child Welfare
Patient care
03 medical and health sciences
0302 clinical medicine
children
Medicine
Humans
Quality of care
Quality of Health Care
Dehydration
business.industry
qualité
hôpitaux
Public Health, Environmental and Occupational Health
Infant, Newborn
Disease Management
Infant
Process of care
Methods observational
3. Good health
diarrhoea
Infectious Diseases
quality
Who guidelines
Child, Preschool
Emergency medicine
Parasitology
Original Article
Female
business
hospitals
Original Research Papers
Child, Hospitalized
Subjects
Details
- Language :
- English
- ISSN :
- 13653156 and 13602276
- Volume :
- 24
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Tropical Medicine & International Health
- Accession number :
- edsair.doi.dedup.....b01db2bb9154d43bd25688ca699ac914