Publication:
Multilevel impacts of a pediatric early warning system in resource-limited pediatric oncology hospitals

Simple item page
dc.contributor.authorMirochnick, Emily
dc.contributor.authorGraetz, Dylan E
dc.contributor.authorFerrara, Gia
dc.contributor.authorPuerto-Torres, Maria
dc.contributor.authorGillipelli, Srinithya R
dc.contributor.authorElish, Paul
dc.contributor.authorMuniz-Talavera, Hilmarie
dc.contributor.authorGonzalez-Ruiz, Alejandra
dc.contributor.authorArmenta, Miriam
dc.contributor.authorBarra, Camila
dc.contributor.authorDiaz-Coronado, Rosdali
dc.contributor.authorHernandez, Cinthia
dc.contributor.authorJuarez, Susana
dc.contributor.authorLoeza, Jose de Jesus
dc.contributor.authorMendez, Alejandra
dc.contributor.authorMontalvo, Erika
dc.contributor.authorPenafiel, Eulalia
dc.contributor.authorPineda, Estuardo
dc.contributor.authorAgulnik, Asya
dc.date.accessioned2024-08-15T14:07:16Z
dc.date.available2024-08-15T14:07:16Z
dc.date.issued2022
dc.description.abstractBackground: Pediatric Early Warning Systems (PEWS) reduce clinical deterioration, improve interdisciplinary communication, and provide cost savings; however, little is known about how these impacts are achieved or related. This study evaluates the multi-level impacts of PEWS in resource-limited pediatric oncology centers. Methods: We conducted 71 semi-structured interviews including physicians (45%), nurses (45%), and administrators (10%) from 5 resource-limited pediatric oncology centers in 4 Latin American countries. Interviews were conducted in Spanish, transcribed, and translated into English. A code book was developed using a priori and inductively derived codes. Transcripts were independently coded by 2 coders, achieving a kappa of 0.8-0.9. Thematic content analysis explored perceived impacts of PEWS at the level of the patient, clinician, healthcare team, and institution. Results: PEWS improved the quality of attention for patients, reducing morbidity and mortality. Clinicians felt more knowledgeable, confident, and empowered providing patient care, resulting in greater job satisfaction. PEWS affected team dynamics by improving interdisciplinary (ward and intensive care unit) and interprofessional (physicians and nurses) relationships and communication. This ultimately led to institutional culture change with emphasis on patient safety, collaboration with other centers, and receipt of institutional awards. Together, these impacts led to hospital-wide support of ongoing PEWS use. Conclusions: In resource-limited hospitals, PEWS use results in multi-level positive impacts on patients, clinicians, teams, and institutions, creating a feedback loop that further supports ongoing PEWS use. These findings can guide advocacy for PEWS to various stakeholders, improve PEWS effectiveness, and inform assessment of other interventions to improve childhood cancer outcomes. Keywords: Latin America; Pediatric Early Warning System (PEWS); global health; pediatric critical care; pediatric oncology; quality improvement; resource-limited. Copyright © 2022 Mirochnick, Graetz, Ferrara, Puerto-Torres, Gillipelli, Elish, Muniz-Talavera, Gonzalez-Ruiz, Armenta, Barra, Diaz-Coronado, Hernandez, Juarez, Loeza, Mendez, Montalvo, Penafiel, Pineda and Agulnik.
dc.identifier.citationMirochnick E, Graetz DE, Ferrara G, Puerto-Torres M, Gillipelli SR, Elish P, Muniz-Talavera H, Gonzalez-Ruiz A, Armenta M, Barra C, Diaz-Coronado R, Hernandez C, Juarez S, Loeza JJ, Mendez A, Montalvo E, Penafiel E, Pineda E, Agulnik A. Multilevel impacts of a pediatric early warning system in resource-limited pediatric oncology hospitals. Front Oncol. 2022 Oct 12;12:1018224. doi: 10.3389/fonc.2022.1018224. PMID: 36313665; PMCID: PMC9597682.
dc.identifier.urihttp://biblioteca.solcaquito.org.ec:9997/handle/123456789/1576
dc.language.isoen
dc.titleMultilevel impacts of a pediatric early warning system in resource-limited pediatric oncology hospitals
dc.typeBook
dspace.entity.typePublication
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
fonc-12-1018224.pdf
Size:
772.01 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed to upon submission
Description:
Download
Collections
PubMed