Implementation of the WHO standards to assess the quality of care for children with acute diarrhoea: findings of a multicentre study (CHOICE) in Italy.

Autor:	Lazzerini M; Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.; London School of Hygiene & Tropical Medicine, London, UK., Sforzi I; Department of Pediatric Emergency Medicine and Trauma Center, IRCCS Meyer Children's University Hospital, Florence, Italy., Liguoro I; Santa Maria della Misericordia University Hospital, Udine, Friuli-Venezia Giulia, Italy., Felici E; Azienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo Alessandria, Alessandria, Piemonte, Italy., Martelossi S; Department of Pediatrics, Treviso Hospital, Treviso, Italy., Bressan S; Department of Women's and Children's Health, University of Padova, Padova, Italy., Trobia GL; Azienda Ospedaliera Cannizzaro, Catania, Italy., Lubrano R; Department of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy., Fasoli S; Department of Pediatrics, 'Carlo Poma' Hospital, Mantova, Italy., Troisi A; Department of Pediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy., Pandullo M; Santa Maria della Misericordia University Hospital, Udine, Friuli-Venezia Giulia, Italy., Gagliardi M; Azienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo Alessandria, Alessandria, Piemonte, Italy., Moras P; Department of Pediatrics, Treviso Hospital, Treviso, Italy., Galiazzo S; Department of Women's and Children's Health, University of Padova, Padova, Italy., Arrabito M; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy., Sanseviero M; Department of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy., Labruzzo M; Department of Pediatrics, 'Carlo Poma' Hospital, Mantova, Italy., Dal Bo S; Department of Pediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy., Baltag V; Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland., Dalena P; Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy paolo.dalena@burlo.trieste.it.; University of Trieste, Trieste, Italy.
Jazyk:	angličtina
Zdroj:	BMJ paediatrics open [BMJ Paediatr Open] 2024 Aug 30; Vol. 8 (Suppl 7). Date of Electronic Publication: 2024 Aug 30.
DOI:	10.1136/bmjpo-2024-002569
Abstrakt:	Background: There is no documented experience in the use of the WHO standards for improving the quality of care (QOC) for children at the facility level. We describe the use of 10 prioritised WHO-Standard-based Quality Measures to assess QOC for children with acute diarrhoea (AD) in Italy. Methods: In a multicentre observational study in 11 paediatric emergency departments with different characteristics and geographical location, we collected data on 3061 children aged 6 months to 15 years with AD and no complications. Univariate and multivariate analyses were conducted. Results: Study findings highlighted both good practices and gaps in QoC, with major differences in QOC across facilities. Documentation of body weight and temperature varied from 7.7% to 98.5% and from 50% to 97.7%, respectively (p<0.001); antibiotic and probiotic prescription rates ranged from 0% to 10.1% and from 0% to 80.8%, respectively (p<0.001); hospitalisations rates ranged between 8.5% and 62.8% (p<0.001); written indications for reassessment were provided in 10.4%-90.2% of cases (p<0.001). When corrected for children's individual characteristics, the variable more consistently associated with each analysed outcome was the individual facility. Higher rates of antibiotics prescription (+7.6%, p=0.04) and hospitalisation (+52.9%, p<0.001) were observed for facilities in Southern Italy, compared with university centres (-36%, p<0.001), independently from children characteristics. Children's clinical characteristics in each centre were not associated with either hospitalisation or antibiotic prescription rates. Conclusions: The 10 prioritised WHO-Standard-based Quality Measures allow a rapid assessment of QOC in children with AD. Action is needed to identify and implement sustainable and effective interventions to ensure high QOC for all children. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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