2023-09-28 14:46:10 +00:00
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abstract: 'Background: An emergency triage, assessment and treatment plus admission
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care (ETAT+) intervention was implemented in Rwandan district hospitals
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to improve hospital care for severely ill infants and children. Many
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interventions are rarely implemented with perfect fidelity under
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real-world conditions. Thus, evaluations of the real-world experiences
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of implementing ETAT+ are important in terms of identifying potential
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barriers to successful implementation. This study explored the
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perspectives of Rwandan healthcare workers (HCWs) on the relevance of
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ETAT+ and documented potential barriers to its successful
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implementation.
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Methods: HCWs enrolled in the ETAT+ training were asked, immediately
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after the training, their perspective regarding (i) relevance of the
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ETAT+ training to Rwandan district hospitals; (ii) if attending the
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training would bring about change in their work; and (iii) challenges
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that they encountered during the training, as well as those they
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anticipated to hamper their ability to translate the knowledge and
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skills learned in the ETAT+ training into practice in order to improve
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care for severely ill infants and children in their hospitals. They
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wrote their perspectives in French, Kinyarwanda, or English and
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sometimes a mixture of all these languages that are official in the
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post-genocide Rwanda. Their notes were translated to (if not already in)
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English and transcribed, and transcripts were analyzed using thematic
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content analysis.
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Results: One hundred seventy-one HCWs were included in our analysis.
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Nearly all these HCWs stated that the training was highly relevant to
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the district hospitals and that it aligned with their work expectation.
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However, some midwives believed that the ``neonatal resuscitation and
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feeding{''''} components of the training were more relevant to them than
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other components. Many HCWs anticipated to change practice by initiating
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a triage system in their hospital and by using job aids including
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guidelines for prescription and feeding. Most of the challenges stemmed
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from the mode of the ETAT+ training delivery (e.g., language barriers,
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intense training schedule); while others were more related to uptake of
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guidelines in the district hospitals (e.g., staff turnover, reluctance
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to change, limited resources, conflicting protocols).
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Conclusion: This study highlights potential challenges to successful
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implementation of the ETAT+ clinical practice guidelines in order to
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improve quality of hospital care in Rwandan district hospitals.
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Understanding these challenges, especially from HCWs perspective, can
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guide efforts to improve uptake of clinical practice guidelines
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including ETAT+ in Rwanda.'
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affiliation: 'Hategeka, C (Corresponding Author), Rwanda Paediat Assoc, ETAT Program,
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Kigali, Rwanda.
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Hategeka, C (Corresponding Author), Univ British Columbia, Fac Med, Sch Populat
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\& Publ Hlth, Vancouver, BC, Canada.
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Hategeka, Celestin; Tuyisenge, Lisine, Rwanda Paediat Assoc, ETAT Program, Kigali,
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Rwanda.
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Hategeka, Celestin, Univ British Columbia, Fac Med, Sch Populat \& Publ Hlth, Vancouver,
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BC, Canada.
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Mwai, Leah, Int Dev Res Ctr, Maternal \& Child Hlth Program, Ottawa, ON, Canada.
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Mwai, Leah, Afya Res Afr, Nairobi, Kenya.
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Tuyisenge, Lisine, Univ Teaching, Hosp Kigali, Dept Pediat, Kigali, Rwanda.'
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article-number: '256'
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author: Hategeka, Celestin and Mwai, Leah and Tuyisenge, Lisine
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author-email: celestin.hategeka@alumni.ubc.ca
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author_list:
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- family: Hategeka
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given: Celestin
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- family: Mwai
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given: Leah
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- family: Tuyisenge
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given: Lisine
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da: '2023-09-28'
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doi: 10.1186/s12913-017-2193-4
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files: []
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issn: 1472-6963
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journal: BMC HEALTH SERVICES RESEARCH
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keywords: 'Implementation; Clinical practical guidelines; ETAT; Healthcare worker;
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District hospital; Qualitative research; Rwanda'
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keywords-plus: KNOWLEDGE; PROGRAM; KENYA
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language: English
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month: APR 7
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number-of-cited-references: '42'
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orcid-numbers: Hategeka, Celestin/0000-0001-7808-4652
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papis_id: 1b5a0b8a135b771103d6f1d8e83016f6
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ref: Hategeka2017implementingemergenc
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times-cited: '27'
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title: 'Implementing the Emergency Triage, Assessment and Treatment plus admission
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care (ETAT plus ) clinical practice guidelines to improve quality of hospital care
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in Rwandan district hospitals: healthcare workers'' perspectives on relevance and
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challenges'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000398622000001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '17'
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web-of-science-categories: Health Care Sciences \& Services
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year: '2017'
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