Resultados de Búsqueda por Autor

1

artículo

Multilevel impacts of a pediatric early warning system in resource-limited pediatric oncology hospitals

Publicado por
Mirochnick, E, Graetz, DE, 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, Penafiel, E, Pineda, E, Agulnik, A

Publicado 2022

Enlace

Background: Pediatric Early Warning Systems (PEWS) reduce clinical deterioration, improve interdisciplinary communication, and provide cost savings

2

artículo

Assessment of Barriers and Enablers to Implementation of a Pediatric Early Warning System in Resource-Limited Settings

Publicado por
Agulnik, Asya, Ferrara, Gia, Puerto-Torres, María, Gillipelli, SR, Elish, Paul, Muniz-Talavera, Hilmarie, Gonzalez-Ruiz, A, Armenta, M, Barra, C, Diaz, R, Hernandez, C, Juarez Tobias, S, De Jesus Loeza, J, Mendez, A, Montalvo, E, Penafiel, E, Pineda, E, Graetz, DE

Publicado 2022

Enlace

Importance: Pediatric early warning systems (PEWS) aid with early identification of clinical deterioration and improve outcomes in children with cancer hospitalized in resource-limited settings

3

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...

4

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...

5

artículo

Challenges to sustainability of pediatric early warning systems (PEWS) in low-resource hospitals in Latin America

Publicado por
Agulnik, A, Schmidt-Grimminger, G, 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, JJ, Mendez, A, Montalvo, E, Penafiel, E, Pineda, E, Graetz, DE, McKay, V

Publicado 2022

Enlace

Background: Sustainability, or continued use of evidence-based interventions for long-term patient benefit, is the least studied aspect of implementation science. In this study, we evaluate sustainability of a Pediatric Early Warning System (PEWS), an evidence-based intervention to improve early identification of clinical deterioration in hospitalized children, in low-resource settings using the Clinical Capacity for Sustainability Framework (CCS). Methods: We conducted a secondary analysis of a qualitative study to identify barriers and enablers to PEWS implementation. Semi-structured interviews with PEWS implementation leaders and hospital directors at 5 Latin American pediatric oncology centers sustaining PEWS were conducted virtually in Spanish from June to August 2020. Interviews were recorded, professionally transcribed, and translated into English. Exploratory thematic content ana...

6

artículo

Documenting adaptations to an evidence-based intervention in 58 resource-variable pediatric oncology hospitals across implementation phases

Publicado por
Quesada-Stoner, AC, Islam, S, Siječić, A, Malone, S, Puerto-Torres, MF, Cardenas, A, Prewitt, K, Alfonso, Carreras, Y, Alvarez-Arellano, SY, Argüello-Vargas, D, Ceballo-Batista, GI, Diaz-Coronado, R, Diniz, Borborema, MDC, Toledo, JE, Fing, E, Garay, Z, Hernández-González, CJ, Jimenez-Antolinez, YV, Juárez, Tobías, MS, Lemos, de, Mendonça, e, Fontes, L, Lopez-Facundo, NA, Mijares, Tobias, JM, Miralda-Méndez, ST, Montalvo, E, Cawich, ZN, Portilla, Figueroa, CA, Sahonero, M, Sánchez-Martín, M, Serrano-Landivar, MX, Soledad, García, V, Vasquez, A, Velásquez, Cabrera, DM, Carothers, BJ, Shelton, RC, Graetz, D, Acuña, C, Luke, DA, McKay, VRR, Agulnik, A

Publicado 2024

Enlace

Background: Adaptation of evidence-based interventions (EBIs) often occurs when implemented in new local contexts and settings. It is unclear, however, during which phase of implementation adaptations are most frequently made and how these changes may impact the fidelity, effectiveness, and sustainability of the EBI. Pediatric Early Warning Systems (PEWS) are EBIs for early identification of deterioration in hospitalized children with cancer. This study evaluates adaptations of PEWS made among resource-variable pediatric oncology hospitals in Latin America implementing and sustaining PEWS. Methods: We conducted a cross-sectional survey among pediatric oncology centers participating in Proyecto Escala de Valoración de Alerta Temprana (EVAT), a collaborative to implement PEWS. Adaptations to PEWS were assessed via 3 multiple choice and 1 free text question administered as part of a large...