‘Involve those who are managing these outbreaks’: stakeholders’ perspectives on the barriers and facilitators to the implementation of clinical management guidelines for high-consequence infectious diseases in Uganda—a thematic network analysis

BMJ Public Health, Год журнала: 2025, Номер 3(1), С. e001165 - e001165

Опубликована: Фев. 1, 2025

Introduction Prior research highlighting the complexity of clinical management guidelines’ (CMGs) implementation during high consequence infectious disease (HCID) outbreaks has suggested that limited access to treatments and equipment substantial issues regarding availability, inclusivity, quality applicability hinders CMGs in low- middle-income countries (LMICs). This in-depth case study Uganda—coincidentally occurring 2022 Sudan virus outbreak—aimed explore contextual supplementary factors which hinder or facilitate CMG development implementation. Methods Between August December 2022, 43 interviews were conducted with medical personnel, consultant physicians, managers Uganda Ministry Health officials. Interviews analysed using a thematic network analysis approach visualise codes qualitative data highlight inherent relationships between codes. Results Six topics emerged as main barriers HCID Uganda: (1) deficient content slow updates CMGs; (2) scarce resources healthcare disparities; (3) dissemination guidelines; (4) improvisation patient care (5) lack training for workers (HCWs); (6) pandemic preparedness response infrastructure. Codes most strongly linked facilitators suggestions included: HCW implementation; adequate resourcing; involvement personnel prior experience improvements CMGs. Conclusions By illustrating linkages resource constraints, disparities, surveillance referral infrastructure, our displays how insufficient training, patchy updating exacerbate many underlying difficulties LMIC contexts. Findings offer valuable insights LMICs improve outbreak responses inform future outbreaks, where evidence is often initially limited. Recommendations enhance are provided.

Язык: Английский

Exploring the impact of interaction dynamics and professional capacity and development on cognitive medical errors: a multiple-case study of healthcare professionals in Jordan

BMC Medical Education, Год журнала: 2025, Номер 25(1)

Опубликована: Апрель 23, 2025

Addressing cognitve medical errors (MEs) and their contributing factors has emerged as a crucial factor in enhancing patient safety attaining improved clinical outcomes. This study aimed to examine the impact of interaction dynamics professional capability development on cognitive MEs (i.e., mistakes, slips, or lapses) from perspectives healthcare professionals Jordan. A multiple-case design was employed with cross-sectional approach. Our investigated three prominent Jordanian hospitals northern region (government, private, teaching) through pretested, valid, reliable survey. Using convenience sampling, 400 participants occupational categories, including physicians, nurses, managers were invloved. The relationships among variables examined structural equation modeling (SEM) following Confirmatory Factor Analysis (CFA) conducted using AMOS software. results CFA demonstrated that model fit indices are acceptable (RMSEA = 0.069; CFI 0.901; Chisq/df 2.92; p <.05). SEM analysis revealed significant positive association between gaps capacity development, which comprises subscales: training needs, continuous education, skills, abilities, competencies professionals, (β 0.40; In contrast, negative correlation found two interpersonal communication, teamwork mutual support, - 0.21; findings advocate for fostering hospital culture consolidates efforts prioritize care coordination, cohesion, while also minimizing unmet needs continuing addressing shortcomings skills job competence essential proactive steps migirate hospitals.

Язык: Английский

What would have made work in the COVID‐19 ICU less demanding? A qualitative study from 13 Swedish COVID‐19 ICUs

Acta Anaesthesiologica Scandinavica, Год журнала: 2024, Номер 68(10), С. 1436 - 1445

Опубликована: Авг. 26, 2024

Abstract Background The COVID‐19 pandemic stretched Swedish intensive care unit (ICU) resources to an extent never experienced before, but even before the staffing was difficult and number of staffed ICU beds low. Studies have revealed high levels staff burn‐out fatigue, as similar situations with demands are likely occur in future a better understanding that improve resilience is important. Using job‐demand resource theory framework, we explored professionals’ views on when working ICUs aim highlight factors increased job resources. Methods Data were collected via web survey distributed professionals, including both regular temporary roles, 13 wards Stockholm Sörmland counties during spring 2021. A total 251 written responses question “What would made work less demanding?” analyzed using thematic analysis. One year later member‐checking focus group interview conducted validate further explore experiences. Results main themes strategy, fairness support, continuity, accessible leadership, introduction/information, crisis preparedness. analysis confirmed results extreme initial stages pandemic. Conclusion To increase health performance long‐term our suggest; maintaining workplace scheduling advance and, possible, schedule for recovery.

Язык: Английский