Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool.

Autor: Mawji A; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, 217-2176 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada. alishah.mawji@bcchr.ca., Li E; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada., Komugisha C; Walimu, P.O. Box 9924, Plot 5-7, Coral Crescent, Kololo, Kampala, Uganda., Akech S; Kenya Medical Research Institute/Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya., Dunsmuir D; Digital Health Innovation Lab, BC Children's Hospital Research Institute, 948 W 28th Ave, Vancouver, BC, V5Z 4H4, Canada., Wiens MO; Center for International Child Health, BC Children's Hospital Research Institute, 948 W 28th Ave, Vancouver, BC, V5Z 4H4, Canada., Kissoon N; Department of Pediatrics, University of British Columbia, Rm B2W, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada., Kenya-Mugisha N; Walimu, P.O. Box 9924, Plot 5-7, Coral Crescent, Kololo, Kampala, Uganda., Tagoola A; Jinja Reginal Referral Hospital, Jinja, Uganda., Kimutai D; Mbagathi County Hospital, P.O. Box 20725-00202, Nairobi, Kenya., Bone JN; Department of Obstetrics and Gynaecology, University of British Columbia, 1125 Howe Street, Vancouver, BC, V6Z 2K8, Canada., Dumont G; Electrical and Computer Engineering, The University of British Columbia, 5500 - 2332 Main Mall, Vancouver, BC, V6T 1Z4, Canada., Ansermino JM; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, 217-2176 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2020 Jun 03; Vol. 20 (1), pp. 493. Date of Electronic Publication: 2020 Jun 03.
DOI: 10.1186/s12913-020-05344-w
Abstrakt: Background: Sepsis is the leading cause of death and disability in children. Every hour of delay in treatment is associated with an escalating risk of morbidity and mortality. The burden of sepsis is greatest in low- and middle-income countries where timely treatment may not occur due to delays in diagnosis and prioritization of critically ill children. To circumvent these challenges, we propose the development and clinical evaluation of a digital triage tool that will identify high risk children and reduce time to treatment. We will also implement and clinically validate a Radio-Frequency Identification system to automate tracking of patients. The mobile platform (mobile device and dashboard) and automated patient tracking system will create a low cost, highly scalable solution for critically ill children, including those with sepsis.
Methods: This is pre-post intervention study consisting of three phases. Phase I will be a baseline period where data is collected on key predictors and outcomes before implementation of the digital triage tool. In Phase I, there will be no changes to healthcare delivery processes in place at the study hospitals. Phase II will involve model derivation, technology development, and usability testing. Phase III will be the intervention period where data is collected on key predictors and outcomes after implementation of the digital triage tool. The primary outcome, time to treatment initiation, will be compared to assess effectiveness of the digital health intervention.
Discussion: Smart technology has the potential to overcome the barrier of limited clinical expertise in the identification of the child at risk. This mobile health platform, with sensors and data-driven applications, will provide real-time individualized risk prediction to rapidly triage patients and facilitate timely access to life-saving treatments for children in low- and middle-income countries, where specialists are not regularly available and deaths from sepsis are common.
Trial Registration: Clinical Trials.gov Identifier: NCT04304235, Registered 11 March 2020.
Databáze: MEDLINE
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