Implementing WHO hospital guidelines improves quality of paediatric care in central hospitals in Lao PDR

Title
Implementing WHO hospital guidelines improves quality of paediatric care in central hospitals in Lao PDR
Authors
Gray, AZ; Soukaloun, D; Soumphonphakdy, B; Duke, T
Keywords
CHILDREN; INDONESIA; STATE
Issue Date
2015
Publisher
TROP MED INT HEALTH
Citation
Trop. Med. Int. Health;APR;2015;20;4
Abstract
ObjectivesTo evaluate the impact of implementing a multifaceted intervention based on the WHO Pocketbook of Hospital Care for Children on the quality of case management of common childhood illnesses in hospitals in Lao PDR. MethodsThe quality of case management of four sentinel conditions was assessed in three central hospitals before and after the implementation of the WHO Pocketbook as part of a broader mixed-methods study. Data on performance of key steps in case management in more than 600 admissions were collected by medical record abstraction pre- and post-intervention, and change was measured according to the proportion of cases which key steps were performed as well as an overall score of case management for each condition. ResultsImprovements in mean case management scores were observed post-intervention for three of the four conditions, with the greatest change in pneumonia (53-91%), followed by diarrhoea and low birthweight. Rational drug prescribing, appropriate use of IV fluids and appropriate monitoring all occurred more frequently post-intervention. Non-recommended practices such as prescription of antitussives became less frequent. ConclusionsA multifaceted intervention based on the WHO Pocketbook of Hospital Care for children led to better paediatric care in central Lao hospitals. The degree of improvement was dependent on the condition assessed. ObjectifsEvaluer l'impact de l'implementation d'une intervention a multi-facettes basee sur le livret OMS des soins hospitaliers pour les enfants, sur la qualite de la prise en charge des cas de maladies infantiles courantes dans les hopitaux au Laos. MethodesLa qualite de la prise en charge des cas de quatre conditions sentinelles a ete evaluee dans trois hopitaux centraux avant et apres l'implementation des directives du livret OMS dans le cadre d'une etude plus large sur des methodes mixtes. Les donnees sur la performance des etapes cles dans la prise en charge des cas dans plus de 600 admissions ont ete recueillies a partir des dossiers medicaux pre et post-intervention, et le changement a ete mesure en fonction de la proportion des cas pour lesquels les etapes cles ont ete realisees ainsi qu'un score global de la prise en charge des cas pour chaque condition. ResultatsDes ameliorations des scores moyens de la prise en charge des cas ont ete observees post-intervention pour trois des quatre conditions, avec le plus grand changement dans la pneumonie (53% a 91%), suivie de diarrhee et du faible poids de naissance. La prescription rationnelle des medicaments, l'utilisation appropriee des fluides IV et la surveillance appropriee ont ete realisees plus souvent post-intervention. Des pratiques non recommandees telles que la prescription d'antitussifs sont devenues moins frequentes. ConclusionsUne intervention a multi-facettes basee sur le livret OMS des soins hospitaliers pour les enfants a conduit a de meilleurs soins pediatriques dans les hopitaux centraux du Laos. Le degre d'amelioration dependait de la condition evaluee. ObjetivosEvaluar el impacto de implementar una intervencion multifacetica, basada en el Libro de Bolsillo de la OMS para el Cuidado Hospitalario de los Ninos, sobre la calidad del manejo de casos de enfermedades pediatricas comunes en hospitales en Lao PDR. MetodosSe evaluo la calidad del manejo de casos de cuatro condiciones centinela en tres hospitales centrales, antes y despues de la implementacion del Libro de Bolsillo de la OMS, como parte de un estudio mas amplio de metodos mixtos. Se recolectaron datos sobre el desempeno del manejo de casos en pasos clave en mas de 600 admisiones mediante la normalizacion de historias clinicas antes y despues de la intervencion. El cambio se midio segun la proporcion de casos en los que se habian realizado los pasos clave al igual que segun el puntaje total del manejo de casos para cada condicion. ResultadosSe observaron mejoras en los puntajes medios de manejo de casos post-intervencion para tres de las cua...
URI
http://hdl.handle.net/11267/2361
ISSN
1360-2276
Appears in Collections:
5.Mahosot Hospital > Journal articles
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