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1

artículo

Effect of paediatric early warning systems (PEWS) implementation on clinical deterioration event mortality among children with cancer in resource-limited hospitals in Latin America...

Publicado por
Agulnik, A, Muniz-Talavera, H, Pham, LTD, Chen, Y, Carrillo, AK, Cárdenas-Aguirre, A, Gonzalez-Ruiz, A, Garza, M, Conde-Morelos-Zaragoza, TM, Soberanis-Vasquez, DJ, Méndez-Aceituno, A, Acuña-Aguirre, C, Alfonso-Carreras, Y, Alvarez-Arellano, SY, Andrade Sarmiento, LA, Batista, R, Blasco Arriaga, EE, Calderon, P, Chavez-Rios, M, Costa, ME, Díaz-Coronado, R, Fing-Soto, EA, Gomez-Garcia, WC, Herrera-Almanza, M, Juarez-Tobias MS, Leon-Lopez, EM, Lopez-Facundo, NA, Martinez-Soria, RA, Miller, K, Miralda-Mendez, ST, Mora-Robles, LN, Negroe-Ocampo, N.D.C, Noriega Acuña B, Osuna-Garcia, A, Pérez-Alvarado, CM, Pérez-Fermin, CK, Pineda-Urquilla, EE, Portilla-Figueroa, CA, Ríos-Lopez, LE, Rivera-Mijares, J, Soto-Chávez, V, Suarez-Soto, JI, Teixeira-Costa, J, Tejocote-Romero, I, Villanueva-Hoyos, EE, Villegas-Pacheco, M, Devidas, M, Rodriguez-Galindo, C

Publicado 2023

Enlace

Background: Paediatric early warning systems (PEWS) aid in the early identification of clinical deterioration events in children admitted to hospital. We aimed to investigate the effect of PEWS implementation on mortality due to clinical deterioration in children with cancer in 32 resource-limited hospitals across Latin America. Methods: Proyecto Escala de Valoración de Alerta Temprana (Proyecto EVAT) is a quality improvement collaborative to implement PEWS in hospitals providing childhood cancer care. In this prospective, multicentre cohort study, centres joining Proyecto EVAT and completing PEWS implementation between April 1, 2017, and May 31, 2021, prospectively tracked clinical deterioration events and monthly inpatient-days in children admitted to hospital with cancer. De-identified registry data reported between April 17, 2017, and Nov 30, 2021, from all hospitals were included i...

2

artículo

Stages of change: Strategies to promote use of a Pediatric Early Warning System in resource-limited pediatric oncology centers

Publicado por
Woo, MC, Ferrara, G, Puerto-Torres, M, Gillipelli, SR, Elish, P, Muniz-Talavera, H, Gonzalez-Ruiz, A, Armenta, M, Barra, C, Diaz-Coronado, R, Hernandez, C, Juarez, S, Loeza, JDJ, Mendez, A, Montalvo, E, Peñafiel, E, Pineda, E, Graetz, DE, Kortz, T, Agulnik, A

Publicado 2023

Enlace

Background: Pediatric Early Warning Systems (PEWS) assist early detection of clinical deterioration in hospitalized children with cancer. Relevant to successful PEWS implementation, the “stages of change” model characterizes stakeholder support for PEWS based on willingness and effort to adopt the new practice. Methods: At five resource-limited pediatric oncology centers in Latin America, semi-structured interviews were conducted with 71 hospital staff involved in PEWS implementation. Purposive sampling was used to select centers requiring variable time to complete PEWS implementation, with low-barrier centers (3–4 months) and high-barrier centers (10–11 months). Interviews were conducted in Spanish, professionally transcribed, and translated into English. Thematic content analysis explored “stage of change” with constant comparative analysis across stakeholder types and stud...

3

artículo

The COVID-19 Pandemic's impact on sustainability and expansion of a Pediatric Early Warning System in resource-limited hospitals

Publicado por
Wiphatphumiprates, PP, Graetz, DE, Ferrara, G, Puerto-Torres, M, Gillipelli, SR, Elish, P, Muniz-Talavera, H, Gonzalez-Ruiz, A, Armenta, M, Barra, C, Carpio, Z, Hernandez, C, Juarez, S, de-Jesus-Loeza, J, Mendez, A, Montalvo, E, Penafiel, E, Pineda, E, McKay, V, Agulnik, A

Publicado 2023

Enlace

Background: The COVID-19 pandemic impacted healthcare delivery worldwide, including pediatric cancer care, with a disproportionate effect in resource-limited settings. This study evaluates its impact on existing quality improvement (QI) programs. Methods: We conducted 71 semi-structured interviews of key stakeholders at five resource-limited pediatric oncology centers participating in a collaborative to implement Pediatric Early Warning System (PEWS). Interviews were conducted virtually using a structured interview guide, recorded, transcribed, and translated into English. Two coders developed a codebook of a priori and inductive codes and independently coded all transcripts, achieving a kappa of 0.8–0.9. Thematic analysis explored the impact of the pandemic on PEWS. Results: All hospitals reported limitations in material resources, reduction in staffing, and impacts on patient care du...

4

artículo

Resilient health care in global pediatric oncology during the COVID-19 pandemic

Publicado por
Graetz, DE, Sniderman, E, Villegas, CA, Kaye, EC, Ragab, I, Laptsevich, A, Maliti, B, Naidu, G, Huang, H, Gassant, PY, Nunes Silva, L, Arce, D, Montoya Vasquez, J, Arora, RS, Alcasabas, AP, Rusmawatiningtyas, D, Raza, MR, Velasco, P, Kambugu, J, Vinitsky, A, Rodriguez-Galindo, C, Agulnik, A, Moreira DC, COVIMPACT Study Group

Publicado 2021

Enlace

Background: In the face of unprecedented challenges because of coronavirus disease 2019, interdisciplinary pediatric oncology teams have developed strategies to continue providing high-quality cancer care. This study explored factors contributing to health care resilience as perceived by childhood cancer providers in all resource level settings. Methods: This qualitative study consisted of 19 focus groups conducted in 16 countries in 8 languages. Seven factors have been previously defined as important for resilient health care including: 1) in situ practical experience, 2) system design, 3) exposure to diverse views on the patient's situation, 4) protocols and checklists, 5) teamwork, 6) workarounds, and 7) trade-offs. Rapid turn-around analysis focused on these factors. Results: All factors of health care resilience were relevant to groups representing all resource settings. Focus group...