Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Assessment of documented adherence to critical actions in paediatric emergency care at a district-level public hospital in South Africa
Dublin Core
Title
Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Assessment of documented adherence to critical actions in paediatric emergency care at a district-level public hospital in South Africa
African Journal of Emergency Medicine
Assessment of documented adherence to critical actions in paediatric emergency care at a district-level public hospital in South Africa
Subject
Paediatric emergency medicine
Paediatrics
Resource-limited setting
Child health
Quality care
Paediatrics
Resource-limited setting
Child health
Quality care
Description
Introduction: The provision of high-quality care is vital to improve child health and survival rates. A simple,
practice-based tool was recently developed to evaluate the quality of paediatric emergency care in resourcelimited
settings in Africa. This study used the practice-based tool to describe the documented adherence to
critical actions in paediatric emergency care at an urban district-level hospital in South Africa and assess its
relation to clinical outcomes.
Methods: This study is a retrospective observational study covering a 19-month period (September 2017 to March
2019). Patients <13 years old, presenting to the emergency centre with one of six sentinel presentations (seizure,
altered mental status, diarrhoea, fever, respiratory distress and polytrauma) were eligible for inclusion. In the
patients’ files, critical actions specific for each presentation were checked for completion. Post-hoc, a seventh
group ‘multiple diagnoses’ was created for patients with more than one sentinel disease. The action completion
rate was tested for association with clinical outcomes.
Results: In total, 388 patients were included (median age 1.1 years, IQR 0.3–3.6). The action completion rate
varied from 63% (polytrauma) to 90% (respiratory distress). Participants with ≥75% action completion rate
were younger (p < 0.001), presented with high acuity (p < 0.001), were more likely to be admitted (adjusted OR
2.2, 95%CI: 1.2–4.1), and had a hospital stay ≥4 days (adjusted OR 3.4, 95%CI: 1.5–7.9).
Conclusion: A high completion rate was associated with young age, a high patient acuity, hospital admission,
length of hospital stay ≥4 days, and the specific sentinel presentation. Future research should determine whether
or not documented care corresponds with the quality of delivered care and the predictive value regarding clinical
outcome.
practice-based tool was recently developed to evaluate the quality of paediatric emergency care in resourcelimited
settings in Africa. This study used the practice-based tool to describe the documented adherence to
critical actions in paediatric emergency care at an urban district-level hospital in South Africa and assess its
relation to clinical outcomes.
Methods: This study is a retrospective observational study covering a 19-month period (September 2017 to March
2019). Patients <13 years old, presenting to the emergency centre with one of six sentinel presentations (seizure,
altered mental status, diarrhoea, fever, respiratory distress and polytrauma) were eligible for inclusion. In the
patients’ files, critical actions specific for each presentation were checked for completion. Post-hoc, a seventh
group ‘multiple diagnoses’ was created for patients with more than one sentinel disease. The action completion
rate was tested for association with clinical outcomes.
Results: In total, 388 patients were included (median age 1.1 years, IQR 0.3–3.6). The action completion rate
varied from 63% (polytrauma) to 90% (respiratory distress). Participants with ≥75% action completion rate
were younger (p < 0.001), presented with high acuity (p < 0.001), were more likely to be admitted (adjusted OR
2.2, 95%CI: 1.2–4.1), and had a hospital stay ≥4 days (adjusted OR 3.4, 95%CI: 1.5–7.9).
Conclusion: A high completion rate was associated with young age, a high patient acuity, hospital admission,
length of hospital stay ≥4 days, and the specific sentinel presentation. Future research should determine whether
or not documented care corresponds with the quality of delivered care and the predictive value regarding clinical
outcome.
Creator
Esm´ee A. Berends , Elaine Erasmus , Nicole R. van Veenendaal , Suzan N. Mukonkole , Sa’ad Lahri , Dani¨el J. Van Hoving
Source
www.elsevier.com/locate/afjem
Publisher
elsevier
Date
4 September 2020
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Esm´ee A. Berends , Elaine Erasmus , Nicole R. van Veenendaal , Suzan N. Mukonkole , Sa’ad Lahri , Dani¨el J. Van Hoving, “Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Assessment of documented adherence to critical actions in paediatric emergency care at a district-level public hospital in South Africa,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/2592.
African Journal of Emergency Medicine
Assessment of documented adherence to critical actions in paediatric emergency care at a district-level public hospital in South Africa,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/2592.