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Development of the FAST-M maternal sepsis bundle for use in low-resource settings: a modified Delphi process
D Lissauer1,2, J Cheshire3,4, C Dunlop3,4
1Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
BJOG : an International Journal of Obstetrics and Gynaecology
|November 3, 2019
Summary
A new maternal sepsis care bundle, FAST-M, was developed for low-resource settings. This evidence-based bundle focuses on Fluids, Antibiotics, Source control, Transfer, and Monitoring for improved maternal health outcomes.
Area of Science:
- Global Health
- Obstetrics and Gynecology
- Infectious Disease Management
Background:
- Maternal sepsis remains a significant cause of mortality worldwide, particularly in low-resource settings.
- Existing sepsis management protocols may not be feasible or adaptable to resource-limited environments.
- There is a critical need for a standardized, evidence-based care bundle for the initial management of maternal sepsis.
Purpose of the Study:
- To develop a sepsis care bundle tailored for the initial management of maternal sepsis.
- To ensure the bundle's applicability and feasibility in low-resource healthcare settings.
- To gain international consensus on essential components for maternal sepsis management.
Main Methods:
- A modified Delphi process involving international healthcare practitioners (n=143) and an expert panel (n=11).
- Literature review to identify potential interventions for sepsis management.
- Online questionnaires and in-person meetings to achieve consensus on bundle items, considering importance and feasibility.
Main Results:
- Consensus was achieved on five key components after three consultation rounds.
- The selected components form the FAST-M bundle: Fluids, Antibiotics, Source identification and control, Transfer, and Monitoring.
- Both healthcare practitioners and the expert panel identified the same items as most important and feasible.
Conclusions:
- An internationally recognized maternal sepsis care bundle (FAST-M) has been successfully developed.
- This bundle is clinically relevant and designed for effective implementation in low-resource settings.
- The consensus-driven approach ensures the practicality and potential impact of the FAST-M bundle.
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