a multifaceted intervention to implement guidelines and improve admission paediatric care in kenyan district hospitals a cluster randomised trial多方面的干预来实现方针、提高住院儿科护理在肯尼亚地区医院集群随机试验.pdfVIP

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2017-09-05 发布于上海
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a multifaceted intervention to implement guidelines and improve admission paediatric care in kenyan district hospitals a cluster randomised trial多方面的干预来实现方针、提高住院儿科护理在肯尼亚地区医院集群随机试验.pdf

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a multifaceted intervention to implement guidelines and improve admission paediatric care in kenyan district hospitals a cluster randomised trial多方面的干预来实现方针、提高住院儿科护理在肯尼亚地区医院集群随机试验

A Multifaceted Intervention to Implement Guidelines and Improve Admission Paediatric Care in Kenyan District Hospitals: A Cluster Randomised Trial 1 1 1 1 1 2 Philip Ayieko *, Stephen Ntoburi , John Wagai , Charles Opondo , Newton Opiyo , Santau Migiro , 2 3 4 4 1,5 1,4 Annah Wamae , Wycliffe Mogoa , Fred Were , Aggrey Wasunna , Greg Fegan , Grace Irimu , Mike English1,6* 1 KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya, 2 Division of Child Health, Ministry of Public Health and Sanitation, Nairobi, Kenya, 3 Ministry of Medical Services, Nairobi, Kenya, 4 Department of Paediatrics and Child Health, University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya, 5 Infectious Disease Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, 6 Department of Paediatrics, University of Oxford and John Radcliffe Hospital, Headington, Oxford, United Kingdom Abstract Background: In developing countries referral of severely ill children from primary care to district hospitals is common, but hospital care is often of poor quality. However, strategies to change multiple paediatric care practices in rural hospitals have rarely been evaluated. Methods and Findings: This cluster randomized trial was conducted in eight rural Kenyan district hospitals, four of which were randomly assigned to a full intervention aimed at improving quality of clinical care (evidence-based guidelines, training, job aides, local facilitation, supervision,