Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi.
Sepsis is a major global health problem, especially in sub-Saharan Africa. Improving patient care requires that healthcare providers understand patients' priorities and provide quality care within the confines of the context they work. We report the perspectives of patients, caregivers and heal...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000272&type=printable |
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| author | Felix Limbani Olive Kabajaasi Margaret Basemera Kate Gooding Nathan Kenya-Mugisha Mercy Mkandawire Davis Rusoke Shevin T Jacob Anne Ruhweza Katahoire Jamie Rylance African Research Collaboration on Sepsis, Patient Experience Study Group |
| author_facet | Felix Limbani Olive Kabajaasi Margaret Basemera Kate Gooding Nathan Kenya-Mugisha Mercy Mkandawire Davis Rusoke Shevin T Jacob Anne Ruhweza Katahoire Jamie Rylance African Research Collaboration on Sepsis, Patient Experience Study Group |
| author_sort | Felix Limbani |
| collection | DOAJ |
| description | Sepsis is a major global health problem, especially in sub-Saharan Africa. Improving patient care requires that healthcare providers understand patients' priorities and provide quality care within the confines of the context they work. We report the perspectives of patients, caregivers and healthcare workers regarding care quality for patients admitted for sepsis to public hospitals in Uganda and Malawi. This qualitative descriptive study in two hospitals included face-to face semi-structured interviews with purposively selected patients recovering from sepsis, their caregivers and healthcare workers. In both Malawi and Uganda, sepsis care often occurred in resource-constrained environments which undermined healthcare workers' capacity to deliver safe, consistent and accessible care. Constraints included limited space, strained; water, sanitation and hygiene (WASH) amenities and practices, inadequate human and material resources and inadequate provision for basic needs including nutrition. Heavy workloads for healthcare workers strained relationships, led to poor communication and reduced engagement with patients and caregivers. These consequences were exacerbated by understaffing which affected handover and continuity of care. All groups (healthcare workers, patients and caregivers) reported delays in care due to long queues and lack of compliance with procedures for triage, treatment, stabilization and monitoring due to a lack of expertise, supervision and context-specific sepsis management guidelines. Quality sepsis care relies on effective severity-based triaging, rapid treatment of emergencies and individualised testing to confirm diagnosis and monitoring. Hospitals in resource-constrained systems contend with limitations in key resources, including for space, staff, expertise, equipment and medicines, in turn contributing to gaps in areas such as WASH and effective care delivery, as well as communication and other relational aspects of care. These limitations are the predominant challenges to achieving high quality care. |
| format | Article |
| id | doaj-art-592c22b6e6ed44bcb316cbadf0576650 |
| institution | Kabale University |
| issn | 2767-3375 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-592c22b6e6ed44bcb316cbadf05766502025-01-18T05:48:34ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0128e000027210.1371/journal.pgph.0000272Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi.Felix LimbaniOlive KabajaasiMargaret BasemeraKate GoodingNathan Kenya-MugishaMercy MkandawireDavis RusokeShevin T JacobAnne Ruhweza KatahoireJamie RylanceAfrican Research Collaboration on Sepsis, Patient Experience Study GroupSepsis is a major global health problem, especially in sub-Saharan Africa. Improving patient care requires that healthcare providers understand patients' priorities and provide quality care within the confines of the context they work. We report the perspectives of patients, caregivers and healthcare workers regarding care quality for patients admitted for sepsis to public hospitals in Uganda and Malawi. This qualitative descriptive study in two hospitals included face-to face semi-structured interviews with purposively selected patients recovering from sepsis, their caregivers and healthcare workers. In both Malawi and Uganda, sepsis care often occurred in resource-constrained environments which undermined healthcare workers' capacity to deliver safe, consistent and accessible care. Constraints included limited space, strained; water, sanitation and hygiene (WASH) amenities and practices, inadequate human and material resources and inadequate provision for basic needs including nutrition. Heavy workloads for healthcare workers strained relationships, led to poor communication and reduced engagement with patients and caregivers. These consequences were exacerbated by understaffing which affected handover and continuity of care. All groups (healthcare workers, patients and caregivers) reported delays in care due to long queues and lack of compliance with procedures for triage, treatment, stabilization and monitoring due to a lack of expertise, supervision and context-specific sepsis management guidelines. Quality sepsis care relies on effective severity-based triaging, rapid treatment of emergencies and individualised testing to confirm diagnosis and monitoring. Hospitals in resource-constrained systems contend with limitations in key resources, including for space, staff, expertise, equipment and medicines, in turn contributing to gaps in areas such as WASH and effective care delivery, as well as communication and other relational aspects of care. These limitations are the predominant challenges to achieving high quality care.https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000272&type=printable |
| spellingShingle | Felix Limbani Olive Kabajaasi Margaret Basemera Kate Gooding Nathan Kenya-Mugisha Mercy Mkandawire Davis Rusoke Shevin T Jacob Anne Ruhweza Katahoire Jamie Rylance African Research Collaboration on Sepsis, Patient Experience Study Group Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi. PLOS Global Public Health |
| title | Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi. |
| title_full | Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi. |
| title_fullStr | Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi. |
| title_full_unstemmed | Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi. |
| title_short | Facilitating high quality acute care in resource-constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi. |
| title_sort | facilitating high quality acute care in resource constrained environments perspectives of patients recovering from sepsis their caregivers and healthcare workers in uganda and malawi |
| url | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000272&type=printable |
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