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ABSTRACT: Background
Severe acute malnutrition (SAM) is common in low-income countries and is associated with high mortality in young children.Objective
To improve recognition and management of SAM in a tertiary hospital in Malawi.Methods
The impact of multifaceted quality improvement interventions in process measures pertaining to the identification and management of SAM was assessed. Interventions included focused training for clinical staff, reporting process measures to staff, and mobile phone-based group messaging for enhanced communication. This initiative focused on children aged 6-36 months admitted to Kamuzu Central Hospital in Malawi from September 2019 to March 2020. Before-after comparisons were made with baseline data from the year before, and process measures within this intervention period which included three plan-do-study-act (PDSA) cycles were compared.Results
During the intervention period, 418 children had SAM and in-hospital mortality was 10.8%, which was not significantly different from the baseline period. Compared with the baseline period, there was significant improvement in the documentation of full anthropometrics on admission, blood glucose test within 24 hours of admission and HIV testing results by discharge. During the intervention period, amidst increasing patient census with each PDSA cycle, three process measures were maintained (documentation of full anthropometrics, determination of nutritional status and HIV testing results), and there was significant improvement in blood glucose documentation.Conclusion
Significant improvement in key quality measures represents early progress towards the larger goal of improving patient outcomes, most notably mortality, in children admitted with SAM.
SUBMITTER: Vonasek BJ
PROVIDER: S-EPMC8671256 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
Vonasek Bryan J BJ Mhango Susan S Crouse Heather L HL Nyangulu Temwachi T Gaven Wilfred W Ciccone Emily E Kondwani Alexander A Patel Binita B Fitzgerald Elizabeth E
Paediatrics and international child health 20210801 3
<h4>Background</h4>Severe acute malnutrition (SAM) is common in low-income countries and is associated with high mortality in young children.<h4>Objective</h4>To improve recognition and management of SAM in a tertiary hospital in Malawi.<h4>Methods</h4>The impact of multifaceted quality improvement interventions in process measures pertaining to the identification and management of SAM was assessed. Interventions included focused training for clinical staff, reporting process measures to staff, ...[more]