Assessment of documented adherence to critical actions in paediatric emergency care at a district-level public hospital in South Africa

dc.contributor.authorBerends, Esmee A.en_ZA
dc.contributor.authorErasmus, Elaineen_ZA
dc.contributor.authorVan Veenendaal, Nicole R.en_ZA
dc.contributor.authorMukonkole, Suzan N.en_ZA
dc.contributor.authorLahri, Saaden_ZA
dc.contributor.authorVan Hoving, Daniel J.en_ZA
dc.date.accessioned2022-01-26T07:58:12Z
dc.date.available2022-01-26T07:58:12Z
dc.date.issued2021
dc.descriptionCITATION: Berends, E. A., et al. 2021. 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, 11(1):98-104, doi:10.1016/j.afjem.2020.09.001.
dc.descriptionThe original publication is available at https://www.sciencedirect.com/journal/african-journal-of-emergency-medicine
dc.description.abstractIntroduction: 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 resource-limited 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.en_ZA
dc.description.urihttps://www.sciencedirect.com/science/article/pii/S2211419X20300987?via%3Dihub
dc.description.versionPublisher’s version
dc.format.extent7 pages : illustrations
dc.identifier.citationBerends, E. A., et al. 2021. 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, 11(1):98-104, doi:10.1016/j.afjem.2020.09.001
dc.identifier.issn2211-419X (online)
dc.identifier.otherdoi:10.1016/j.afjem.2020.09.001
dc.identifier.urihttp://hdl.handle.net/10019.1/124141
dc.language.isoen_ZAen_ZA
dc.publisherElsevier
dc.rights.holderAuthors retain copyright
dc.subjectPaediatric emergency medicine -- South Africaen_ZA
dc.subjectPatients -- Safety measures -- South Africaen_ZA
dc.subjectPediatric emergencies -- South Africaen_ZA
dc.titleAssessment of documented adherence to critical actions in paediatric emergency care at a district-level public hospital in South Africaen_ZA
dc.typeArticleen_ZA
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