The development of a care bundle to improve the initial management of maternal sepsis for use in low and lower-middle income countries

[摘要] Aims The main objectives for this thesis were: 1. To undertake a systematic review to assess the effectiveness of using care bundles in low and lower-middle income countries (LMIC) 2.To complete a modified Delphi study to gain consensus on the most important and feasible items to be included in a low-income maternal sepsis bundle 3.To develop an exploratory theory of change (TOC) model to assist in planning the implementation of the bundle. Methods To achieve the above aims, a number of research methodologies were used including: systematic review & meta-analysis, modified Delphi and undertaking in-country workshops to develop a TOC. Results A comprehensive literature search identified 2770 citations, 10 of which were included in the systematic review. Meta-analysis showed the use of bundles significantly reduces the incidence of infection. Consensus was achieved after three iterations of the modified Delphi, with the following final bundle item: Fluids, Antibiotics, Source Control, Transport and Monitoring (FAST-M). Multiple workshops were used to build a TOC diagram. Conclusion A low-income maternal sepsis bundle has been produced through international consensus. Framework for an exploratory TOC model has been developed to assist in planning the bundle’s implementation. These findings can be used to design an appropriate feasibility study to pilot the bundle.

[发布机构] University:University of Birmingham;Department:Institute of Metabolism and Systems Research

[关键词] R Medicine;RA Public aspects of medicine;RA0421 Public health. Hygiene. Preventive Medicine