Adherence Associated Factors to the Neonatal Sepsis Clinical Practice Guidelines at the National Maternal Perinatal Institute of Peru

• Autores: Dávila Aliaga, Carmen Rosa, Mendoza Ibañez, Elina, Torres Marcos, Elsa, Arango Ochante, Pedro, Saldaña Diaz, Claudia, Cabanillas Choque, Jannett Consuelo, Vallas Castillo, Jamie Ysabel, Guillén Zambrano, Rayza, Chavez Pita, Julio, Grimaldo D’Ambrosio, Giovanni Giselle, Lozano Dominguez, Jhony
• Formato: artículo
• Fecha de Publicación: 2024
• Institución: Instituto Nacional Materno Perinatal
• Repositorio: Revista Peruana de Investigación Materno Perinatal
• Lenguaje: español
• OAI Identifier: oai:ojs.www.fracturae.com:article/401
• Enlace del recurso: https://investigacionmaternoperinatal.inmp.gob.pe/index.php/rpinmp/article/view/401
• Nivel de acceso: acceso abierto
• Materia: recién nacido; Neonato; guías de práctica clínica; sepsis neonatal; Neonatal Sepsis; Newborn; neonate; Practice Guideline

Introduction: Adherence to clinical practice guidelines (CPG) improves the management of neonatal sepsis, reducing complications and mortality in newborns. Objective: To identify factors associated with adherence to CPG for neonatal sepsis at the Instituto Nacional Materno Perinatal (INMP). Material and Methods: A retrospective case-control study was conducted at the INMP, analyzing 988 neonatal sepsis hospitalizations between May and December 2021. Maternal and neonatal variables were evaluated using a mixed-effects logistic regression model to estimate adjusted prevalence ratios with 95% confidence intervals (CI95%). Results: Overall adherence to CPG was 75%, higher in early-onset sepsis (81,4%) than in late-onset sepsis (66,9%). Late-onset sepsis was associated with lower adherence (adjusted OR=1.37; CI95 %=1.05-1.78; p<0.01). Care provided by non-neonatologist pediatricians reduced adherence (adjusted OR=1.43; CI95 %=1.01-2.02; p=0.046). Mechanical ventilation increased adherence by 40% (adjusted OR=0.60; CI95 %=0.45-0.80). Conclusions: Adherence to CPG is higher in premature neonates and in cases requiring mechanical ventilation. Late-onset sepsis and care provided by non-neonatologist pediatricians reduce adherence. Strengthening training and optimizing CPG implementation are recommended to improve the quality of clinical management in critically ill neonates.