Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, Colorado, USA.
BMJ Open. 2023 Oct 24;13(10):e074458. doi: 10.1136/bmjopen-2023-074458.
New paediatric sepsis criteria are being developed by an international task force. However, it remains unknown what type of clinical decision support (CDS) tools will be most useful for dissemination of those criteria in resource-poor settings. We sought to design effective CDS tools by identifying the paediatric sepsis-related decisional needs of multidisciplinary clinicians and health system administrators in resource-poor settings.
Semistructured qualitative focus groups and interviews with 35 clinicians (8 nurses, 27 physicians) and 5 administrators at health systems that regularly provide care for children with sepsis, April-May 2022.
Health systems in Africa, Asia and Latin America, where sepsis has a large impact on child health and healthcare resources may be limited.
Participants had a mean age of 45 years, a mean of 15 years of experience, and were 45% female.
Emergent themes were related to the decisional needs of clinicians caring for children with sepsis and to the needs of health system administrators as they make decisions about which CDS tools to implement. Themes included variation across regions and institutions in infectious aetiologies of sepsis and available clinical resources, the need for CDS tools to be flexible and customisable in order for implementation to be successful, and proposed features and format of an ideal paediatric sepsis CDS tool.
Findings from this study will directly contribute to the design and implementation of CDS tools to increase the uptake and impact of the new paediatric sepsis criteria in resource-poor settings.
一个国际工作组正在制定新的儿科脓毒症标准。然而,在资源匮乏的环境中,哪种类型的临床决策支持(CDS)工具最有助于传播这些标准仍然未知。我们通过确定资源匮乏环境中多学科临床医生和卫生系统管理人员与儿科脓毒症相关的决策需求,旨在设计有效的 CDS 工具。
2022 年 4 月至 5 月,对经常为脓毒症儿童提供护理的卫生系统中的 35 名临床医生(8 名护士,27 名医生)和 5 名管理人员进行了半结构化定性焦点小组和访谈。
非洲、亚洲和拉丁美洲的卫生系统,这些地区脓毒症对儿童健康和医疗资源的影响很大,医疗资源可能有限。
参与者的平均年龄为 45 岁,平均从业经验为 15 年,女性占 45%。
出现的主题与照顾脓毒症儿童的临床医生的决策需求以及卫生系统管理人员在决定实施哪些 CDS 工具时的需求有关。主题包括不同地区和机构之间脓毒症的感染病因和可用临床资源的差异、CDS 工具需要具有灵活性和可定制性,以便成功实施,以及理想儿科脓毒症 CDS 工具的拟议功能和格式。
本研究的结果将直接有助于设计和实施 CDS 工具,以增加新的儿科脓毒症标准在资源匮乏环境中的采用和影响。