The FAST‐M complex intervention for the detection and management of maternal sepsis in low‐resource settings: a multi‐site evaluation

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The FAST‐M complex intervention for the detection and management of maternal sepsis in low‐resource settings : a multi‐site evaluation. / Cheshire, James; Jones, Laura; Munthali, Laura; Kamphinga, Christopher; Liyaya, Harry; Phiri, Tarcizius; Parry‐Smith, William; Dunlop, Catherine; Makwenda, Charles; Devall, Adam James; Tobias, Aurelio; Nambiar, Bejoy; Merriel, Abi; Williams, Helen ; Gallos, Ioannis; Wilson, Amie; Coomarasamy, Arri; Lissauer, David.

In: BJOG: An International Journal of Obstetrics & Gynaecology, 04.02.2021.

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Cheshire, James ; Jones, Laura ; Munthali, Laura ; Kamphinga, Christopher ; Liyaya, Harry ; Phiri, Tarcizius ; Parry‐Smith, William ; Dunlop, Catherine ; Makwenda, Charles ; Devall, Adam James ; Tobias, Aurelio ; Nambiar, Bejoy ; Merriel, Abi ; Williams, Helen ; Gallos, Ioannis ; Wilson, Amie ; Coomarasamy, Arri ; Lissauer, David. / The FAST‐M complex intervention for the detection and management of maternal sepsis in low‐resource settings : a multi‐site evaluation. In: BJOG: An International Journal of Obstetrics & Gynaecology. 2021.

Bibtex

@article{507db4b0bbcf4d9d91e0b5355e79910a,
title = "The FAST‐M complex intervention for the detection and management of maternal sepsis in low‐resource settings: a multi‐site evaluation",
abstract = "Objective: To evaluate whether the implementation of the FAST-M complex intervention was feasible and improved the recognition and management of maternal sepsis in a low-resource setting. Design: A before-and-after design. Setting: Fifteen government healthcare facilities in Malawi. Population: Women suspected of having maternal sepsis. Methods: The FAST-M complex intervention consisted of the following components: the FAST-M maternal sepsis treatment bundle and the FAST-M implementation programme. Performance of selected process outcomes was compared between a 2-month baseline phase and 6-month intervention phase with compliance used as a proxy measure of feasibility. Main outcome result: Compliance with vital sign recording and use of the FAST-M maternal sepsis bundle. Results: Following implementation of the FAST-M intervention, women were more likely to have a complete set of vital signs taken on admission to the wards (0/163 [0%] versus 169/252 [67.1%], P < 0.001). Recognition of suspected maternal sepsis improved with more cases identified following the intervention (12/106 [11.3%] versus 107/166 [64.5%], P < 0.001). Sepsis management improved, with women more likely to receive all components of the FAST-M treatment bundle within 1 hour of recognition (0/12 [0%] versus 21/107 [19.6%], P = 0.091). In particular, women were more likely to receive antibiotics (3/12 [25.0%] versus 72/107 [67.3%], P = 0.004) within 1 hour of recognition of suspected sepsis. Conclusion: Implementation of the FAST-M complex intervention was feasible and led to the improved recognition and management of suspected maternal sepsis in a low-resource setting such as Malawi. Tweetable Abstract: Implementation of a sepsis care bundle for low-resources improved recognition & management of maternal sepsis.",
keywords = "Care bundle, complex intervention, feasibility study, low-resource setting, maternal sepsis",
author = "James Cheshire and Laura Jones and Laura Munthali and Christopher Kamphinga and Harry Liyaya and Tarcizius Phiri and William Parry‐Smith and Catherine Dunlop and Charles Makwenda and Devall, {Adam James} and Aurelio Tobias and Bejoy Nambiar and Abi Merriel and Helen Williams and Ioannis Gallos and Amie Wilson and Arri Coomarasamy and David Lissauer",
note = "Funding Information: Research funding was provided by MSD for Mothers, University of Birmingham and the charity Ammalife. Funds from MSD were provided through its MSD for Mothers programme. MSD for Mothers is an initiative of Merck & Co., Inc., Kenilworth, N J, USA. DL, AC, JC, AW and CD all work as volunteers with the charity Ammalife. Those engaged in the work were excluded from the funding decision made by Ammalife. None of the funders had input into the study design, data collection, data analysis, data interpretation or writing of the report.",
year = "2021",
month = feb,
day = "4",
doi = "10.1111/1471-0528.16658",
language = "English",
journal = "BJOG: An International Journal of Obstetrics & Gynaecology",
issn = "1470-0328",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - The FAST‐M complex intervention for the detection and management of maternal sepsis in low‐resource settings

T2 - a multi‐site evaluation

AU - Cheshire, James

AU - Jones, Laura

AU - Munthali, Laura

AU - Kamphinga, Christopher

AU - Liyaya, Harry

AU - Phiri, Tarcizius

AU - Parry‐Smith, William

AU - Dunlop, Catherine

AU - Makwenda, Charles

AU - Devall, Adam James

AU - Tobias, Aurelio

AU - Nambiar, Bejoy

AU - Merriel, Abi

AU - Williams, Helen

AU - Gallos, Ioannis

AU - Wilson, Amie

AU - Coomarasamy, Arri

AU - Lissauer, David

N1 - Funding Information: Research funding was provided by MSD for Mothers, University of Birmingham and the charity Ammalife. Funds from MSD were provided through its MSD for Mothers programme. MSD for Mothers is an initiative of Merck & Co., Inc., Kenilworth, N J, USA. DL, AC, JC, AW and CD all work as volunteers with the charity Ammalife. Those engaged in the work were excluded from the funding decision made by Ammalife. None of the funders had input into the study design, data collection, data analysis, data interpretation or writing of the report.

PY - 2021/2/4

Y1 - 2021/2/4

N2 - Objective: To evaluate whether the implementation of the FAST-M complex intervention was feasible and improved the recognition and management of maternal sepsis in a low-resource setting. Design: A before-and-after design. Setting: Fifteen government healthcare facilities in Malawi. Population: Women suspected of having maternal sepsis. Methods: The FAST-M complex intervention consisted of the following components: the FAST-M maternal sepsis treatment bundle and the FAST-M implementation programme. Performance of selected process outcomes was compared between a 2-month baseline phase and 6-month intervention phase with compliance used as a proxy measure of feasibility. Main outcome result: Compliance with vital sign recording and use of the FAST-M maternal sepsis bundle. Results: Following implementation of the FAST-M intervention, women were more likely to have a complete set of vital signs taken on admission to the wards (0/163 [0%] versus 169/252 [67.1%], P < 0.001). Recognition of suspected maternal sepsis improved with more cases identified following the intervention (12/106 [11.3%] versus 107/166 [64.5%], P < 0.001). Sepsis management improved, with women more likely to receive all components of the FAST-M treatment bundle within 1 hour of recognition (0/12 [0%] versus 21/107 [19.6%], P = 0.091). In particular, women were more likely to receive antibiotics (3/12 [25.0%] versus 72/107 [67.3%], P = 0.004) within 1 hour of recognition of suspected sepsis. Conclusion: Implementation of the FAST-M complex intervention was feasible and led to the improved recognition and management of suspected maternal sepsis in a low-resource setting such as Malawi. Tweetable Abstract: Implementation of a sepsis care bundle for low-resources improved recognition & management of maternal sepsis.

AB - Objective: To evaluate whether the implementation of the FAST-M complex intervention was feasible and improved the recognition and management of maternal sepsis in a low-resource setting. Design: A before-and-after design. Setting: Fifteen government healthcare facilities in Malawi. Population: Women suspected of having maternal sepsis. Methods: The FAST-M complex intervention consisted of the following components: the FAST-M maternal sepsis treatment bundle and the FAST-M implementation programme. Performance of selected process outcomes was compared between a 2-month baseline phase and 6-month intervention phase with compliance used as a proxy measure of feasibility. Main outcome result: Compliance with vital sign recording and use of the FAST-M maternal sepsis bundle. Results: Following implementation of the FAST-M intervention, women were more likely to have a complete set of vital signs taken on admission to the wards (0/163 [0%] versus 169/252 [67.1%], P < 0.001). Recognition of suspected maternal sepsis improved with more cases identified following the intervention (12/106 [11.3%] versus 107/166 [64.5%], P < 0.001). Sepsis management improved, with women more likely to receive all components of the FAST-M treatment bundle within 1 hour of recognition (0/12 [0%] versus 21/107 [19.6%], P = 0.091). In particular, women were more likely to receive antibiotics (3/12 [25.0%] versus 72/107 [67.3%], P = 0.004) within 1 hour of recognition of suspected sepsis. Conclusion: Implementation of the FAST-M complex intervention was feasible and led to the improved recognition and management of suspected maternal sepsis in a low-resource setting such as Malawi. Tweetable Abstract: Implementation of a sepsis care bundle for low-resources improved recognition & management of maternal sepsis.

KW - Care bundle

KW - complex intervention

KW - feasibility study

KW - low-resource setting

KW - maternal sepsis

UR - http://www.scopus.com/inward/record.url?scp=85101928860&partnerID=8YFLogxK

U2 - 10.1111/1471-0528.16658

DO - 10.1111/1471-0528.16658

M3 - Article

C2 - 33539610

JO - BJOG: An International Journal of Obstetrics & Gynaecology

JF - BJOG: An International Journal of Obstetrics & Gynaecology

SN - 1470-0328

ER -