Task shifting an inpatient triage, assessment and treatment programme improves the quality of care for hospitalised Malawian children

Tropical Medicine and International Health

Volumn 18, Issue 7, 2013, Pages 879-886

  Olson, Daniel ^a,b   Preidis, Geoffrey A ^c   Milazi, Robert ^d   Spinler, Jennifer K ^c   Lufesi, Norman ^e   Mwansambo, Charles ^d,e   Hosseinipour, Mina C ^b,f   Mccollum, Eric D ^b,g  

^a University of Colorado Denver and Children s Hospital Colorado   (United States)

^b UNIVERSITY OF NORTH CAROLINA PROJECT   (Malawi)

^c TEXAS CHILDREN S HOSPITAL   (United States)

^d KAMUZU CENTRAL HOSPITAL   (Malawi)

^e MINISTRY OF HEALTH   (Malawi)

^f UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

^g JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Inpatient triage assessment and treatment; Malawi; Paediatric early warning score; Pulse oximetry; Task shift; Vital sign

Indexed keywords

ASSESSMENT METHOD; BASELINE SURVEY; CHILD HEALTH; DATA SET; DEVELOPING WORLD; EARLY WARNING SYSTEM; HEALTH WORKER; HOSPITAL SECTOR; MORTALITY;

ARTICLE; CHILD; EMERGENCY HEALTH SERVICE; FEMALE; HEALTH CARE PERSONNEL; HEALTH CARE QUALITY; HOSPITAL PERSONNEL; HUMAN; INFANT; MAJOR CLINICAL STUDY; MALAWI; MALE; MORTALITY; PATIENT MONITORING; PATIENT REFERRAL; PRESCHOOL CHILD; PULSE OXIMETER; SHIFT WORKER; THERMOMETER; VITAL SIGN;

ALLIED HEALTH PERSONNEL; CHILD, HOSPITALIZED; CHILD, PRESCHOOL; COMMUNICATION; FEMALE; HEALTH PERSONNEL; HOSPITAL MORTALITY; HOSPITALIZATION; HOSPITALS; HUMANS; INFANT; MALAWI; MALE; QUALITY IMPROVEMENT; REFERRAL AND CONSULTATION; SEVERITY OF ILLNESS INDEX; TRIAGE; VITAL SIGNS; WORKLOAD;

MALAWI;

EID: 84879196620     PISSN: 13602276     EISSN: 13653156     Source Type: Journal    
DOI: 10.1111/tmi.12114     Document Type: Article

References (39)

1. Awases M, Gbary AR, Nyoni J & Chatora R (2003) Migration of Health Professionals in Six Countries: A Synthesis Report, WHO-AFRO DHS, Brazzaville.
2. Black RE, Cousens S, Johnson HL et al. (2010) Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375, 1969-1987.
3. Brilli RJ, Gibson R, Luria JW et al. (2007) Implementation of a medical emergency team in a large pediatric teaching hospital prevents respiratory and cardiopulmonary arrests outside the intensive care unit. Pediatric Critical Care Medicine 8, 236-246; quiz 247.
4. Chan PS, Jain R, Nallmothu BK, Berg RA & Sasson C (2010) Rapid response teams: a systematic review and meta-analysis. Archives of Internal Medicine 170, 18-26.
5. Chilopora G, Pereira C, Kamwendo F et al. (2007) Postoperative outcome of caesarean sections and other major emergency obstetric surgery by clinical officers and medical officers in Malawi. Human Resources for Health 5, 17.
6. Dovlo D (2004) Using mid-level cadres as substitutes for internationally mobile health professionals in Africa: a desk review. Human Resources for Health 2, 7.
7. Duncan H, Hutchison J & Parshuram CS (2006) The pediatric early warning system score: a severity of illness score to predict urgent medical need in hospitalized children. Journal of Critical Care 21, 271-278.
8. Edwards ED, Powell CV, Mason BW & Oliver A (2009) Prospective cohort study to test the predictability of the Cardiff and Vale paediatric early warning system. Archives of Disease in Childhood 94, 602-606.
9. Egdell P, Finlay L & Pedley DK (2008) The PAWS score: validation of an early warning scoring system for the initial assessment of children in the emergency department. Emergency Medicine Journal 25, 745-749.
10. Gove S, Tamburlini G, Molyneux E, Whitesell P & Campbell H (1999) Development and technical basis of simplified guidelines for emergency triage assessment and treatment in developing countries. WHO integrated management of childhood illness (IMCI) referral care project. Archives of Disease in Childhood 81, 473-477.
11. Haines C, Perrott M & Weir P (2006) Promoting care for acutely ill children-development and evaluation of a paediatric early warning tool. Intensive and Critical Care Nursing 22, 73-81.
12. Haines A, Sanders D, Lehmann U et al. (2007) Achieving child survival goals: potential contribution of community health workers. Lancet 369, 2121-2131.
13. Huicho L, Scherpbier RW, Nkowane AM & Victora CG (2008) How much does quality of child care vary between health workers with differing durations of training? An observational multicountry study. Lancet 372, 910-916.
14. Hunt EA, Zimmer KP, Rinke ML et al. (2008) Transition from a traditional code team to a medical emergency team and categorization of cardiopulmonary arrests in a children's center. Archives of Pediatrics and Adolescent Medicine 162, 117-122.
15. Kotsakis A, Lobos AT, Parshuram C et al. (2011) Implementation of a multicenter rapid response system in pediatric academic hospitals is effective. Pediatrics 128, 72-78.
16. Lehmann U, Van Damme W, Barten F & Sanders D (2009) Task shifting: the answer to the human resources crisis in Africa? Human Resources for Health 7, 49.
17. Lewin SA, Dick J, Pond P et al. (2005) Lay health workers in primary and community health care. Cochrane Database of Systematic Reviews CD004015.
18. Liese B & Dussault G (2004) The State of the Health Workforce in Sub-Saharan Africa: Evidence of Crisis and Analysis of Contributing Factors. The World Bank, Washington, DC.
19. Lozano R, Wang H, Foreman KJ et al. (2011) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet 378, 1139-1165.
20. McCollum ED, Preidis GA, Golitko CL et al. (2011) Routine inpatient human immunodeficiency virus testing system increases access to pediatric human immunodeficiency virus care in sub-Saharan Africa. The Pediatric Infectious Disease Journal 30, e75-e81.
21. Molyneux E, Ahmad S & Robertson A (2006) Improved triage and emergency care for children reduces inpatient mortality in a resource-constrained setting. Bulletin of the World Health Organization 84, 314-319.
22. Monaghan A (2005) Detecting and managing deterioration in children. Paediatric Nursing 17, 32-35.
23. Namathanga A (2011) Emergency Triage, Assessment, and Training (ETAT) 2011 Reports. Kamuzu Central Hospital, Lilongwe, Malawi.
24. Ofori-Adjei D & Arhinful DK (1996) Effect of training on the clinical management of malaria by medical assistants in Ghana. Social Science and Medicine 42, 1169-1176.
25. Olson D, Davis NL & Milazi R et al. Development of a severity of illness scoring system (ITAT) for resource-constrained hospitals in developing countries. Tropical Medicine & International Health, in press.
26. Parshuram CS, Hutchison J & Middaugh K (2009) Development and initial validation of the Bedside Paediatric Early Warning System score. Critical Care 13, R135.
27. Parshuram CS, Bayliss A, Reimer J, Middaugh K & Blanchard N (2011) Implementing the Bedside Paediatric Early Warning System in a community hospital: a prospective observational study. Paediatrics and Child Health 16, e18-e22.
28. Robertson MA & Molyneux EM (2001) Triage in the developing world-can it be done? Archives of Disease in Childhood 85, 208-213.
29. Robinson J, Ahmed Z, Durand C et al. (2011) International child health group, implementation of ETAT (Emergency Triage Assessment and Treatment) in a central hospital in Malawi. Archives of Disease in Childhood 96, A74-A75.
30. Rosedale K, Smith ZA, Davies H & Wood D (2011) The effectiveness of the South African Triage Score (SATS) in a rural emergency department. South African Medical Journal 101, 537-540.
31. Rylance J, Baker T, Mushi E & Mashaga D (2009) Use of an early warning score and ability to walk predicts mortality in medical patients admitted to hospitals in Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene 103, 790-794.
32. Sharek PJ, Parast LM, Leong K et al. (2007) Effect of a rapid response team on hospital-wide mortality and code rates outside the ICU in a Children's Hospital. Journal of the American Medical Association 298, 2267-2274.
33. Shutt MM (1994) Midterm review of the Tanzania Family Planning Services Support (FPSS) Project (621-0173). POPTECH Report No. 94-011-015. In: Population Technical Assistance Project. US Agency for International Development, Washington, DC.
34. Thornley C (2000) A question of competence? Re-evaluating the roles of the nursing auxiliary and health care assistant in the NHS. Journal of Clinical Nursing 9, 451-458.
35. Tibballs J & Kinney S (2006) Evaluation of a paediatric early warning tool-claims unsubstantiated. Intensive and Critical Care Nursing 22, 315-316; author reply 317.
36. Tibballs J & Kinney S (2009) Reduction of hospital mortality and of preventable cardiac arrest and death on introduction of a pediatric medical emergency team. Pediatric Critical Care Medicine 10, 306-312.
37. Tibballs J, Kinney S, Duke T, Oakley E & Hennessy M (2005) Reduction of paediatric in-patient cardiac arrest and death with a medical emergency team: preliminary results. Archives of Disease in Childhood 90, 1148-1152.
38. WHO (2005) Handbook: IMCI Integrated Management of Childhood Illness. World Health Organisation, Geneva, Switzerland.
39. WHO (2006) Treat, Train, Retain: The AIDS and Health Workforce Plan. Report on the Consultation on AIDS and Human Resources for Health, WHO, Geneva. World Health Organization, Geneva. http://www.who.int/hiv/pub/meetingreports/ttr/en/index.html