A mixed method multi-country assessment of barriers to implementing pediatric inpatient care guidelines.
Kirkby D TickellDorothy I MangaleStephanie N Tornberg-BelangerCeline BourdonJohnstone ThitiriMolline TimbwaJenala NjirammadziWieger VoskuijlMohammod J ChistiTahmeed AhmedAbu S M S B ShahidAbdoulaye H DialloIssaka OuédragoMd Alfazal KhanAli F SaleemFehmina ArifZaubina KaziEzekiel MupereJohn MukisaPriya SukhtankarJames Alexander BerkleyJudd L WalsonDonna M Dennonull nullPublished in: PloS one (2019)
Assessed hospitals had the infrastructure and equipment to implement guideline-consistent care. While fluids, appropriate antimalarials and antibiotics, and malnutrition refeeding adherence was comparable to published estimates from low- and high-resource settings, there were inconsistencies in implementation of some other recommendations. Stockouts of essential therapeutics and laboratory reagents were a noted barrier, but facility staff perceived inadequate human resources as the primary constraint to consistent guideline implementation.
Keyphrases
- quality improvement
- healthcare
- palliative care
- primary care
- mental health
- endothelial cells
- clinical practice
- depressive symptoms
- physical activity
- long term care
- small molecule
- pain management
- induced pluripotent stem cells
- type diabetes
- young adults
- insulin resistance
- glycemic control
- metabolic syndrome
- chronic pain