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Clinical decision support tools for paediatric sepsis in resource-poor settings: an international qualitative study
Andrea Jimenez-Zambrano1,2, Carly Ritger2, Margaret Rebull3
1Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Insights
To improve pediatric sepsis care in resource-poor areas, this study identified clinician and administrator needs for effective clinical decision support (CDS) tools. Findings will guide the development of adaptable CDS to implement new sepsis criteria.
Area of Science:
- Global Health
- Pediatric Critical Care
- Health Informatics
Background:
- New pediatric sepsis criteria are emerging from international efforts.
- Disseminating these criteria in resource-limited settings presents challenges.
- The optimal type of clinical decision support (CDS) tools for these settings is unknown.
Purpose of the Study:
- To identify the specific decisional needs of multidisciplinary clinicians and health system administrators.
- To inform the design of effective CDS tools for implementing new pediatric sepsis criteria in resource-poor settings.
Main Methods:
- Qualitative study utilizing semistructured focus groups and interviews.
- Conducted with 35 clinicians (nurses and physicians) and 5 administrators.
- Participants were from health systems in Africa, Asia, and Latin America.
Main Results:
- Identified key decisional needs for clinicians and administrators regarding pediatric sepsis care.
- Highlighted the importance of flexibility and customizability in CDS tools due to regional variations in sepsis etiology and resources.
- Gathered insights into desired features and formats for an ideal pediatric sepsis CDS tool.
Conclusions:
- Understanding local needs is crucial for designing effective CDS tools.
- Flexible and customizable CDS tools are essential for successful implementation of new pediatric sepsis criteria in resource-poor settings.
- Study findings will directly inform the development and implementation of impactful CDS tools.
Objective:
New paediatric sepsis criteria are being developed by an international task force. However, it remains unknown what type of clinical decision support (CDS) tools will be most useful for dissemination of those criteria in resource-poor settings. We sought to design effective CDS tools by identifying the paediatric sepsis-related decisional needs of multidisciplinary clinicians and health system administrators in resource-poor settings.
Design:
Semistructured qualitative focus groups and interviews with 35 clinicians (8 nurses, 27 physicians) and 5 administrators at health systems that regularly provide care for children with sepsis, April-May 2022.
Setting:
Health systems in Africa, Asia and Latin America, where sepsis has a large impact on child health and healthcare resources may be limited.
Participants:
Participants had a mean age of 45 years, a mean of 15 years of experience, and were 45% female.
Results:
Emergent themes were related to the decisional needs of clinicians caring for children with sepsis and to the needs of health system administrators as they make decisions about which CDS tools to implement. Themes included variation across regions and institutions in infectious aetiologies of sepsis and available clinical resources, the need for CDS tools to be flexible and customisable in order for implementation to be successful, and proposed features and format of an ideal paediatric sepsis CDS tool.
Conclusion:
Findings from this study will directly contribute to the design and implementation of CDS tools to increase the uptake and impact of the new paediatric sepsis criteria in resource-poor settings.
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