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  1. Article ; Online: Evaluation of the FAST-M maternal sepsis intervention in Pakistan: A qualitative exploratory study.

    Ahmed, Sheikh Irfan / Khowaja, Bakhtawar M Hanif / Barolia, Rubina / Sikandar, Raheel / Rind, Ghulam Kubra / Jahangir, Arshia / Parveen, Fahmida / Cheshire, James / Dunlop, Catherine / Petrucka, Pammla Margaret / Sheikh, Lumaan / Coomarasamy, Arri / Lissauer, David

    PloS one

    2023  Volume 18, Issue 4, Page(s) e0284530

    Abstract: Introduction: The World Health Organization and partners developed and evaluated a maternity-specific sepsis care bundle called 'FAST-M' for low-resource settings. However, this bundle has not yet been studied in Asia. Our study sought to evaluate the ... ...

    Abstract Introduction: The World Health Organization and partners developed and evaluated a maternity-specific sepsis care bundle called 'FAST-M' for low-resource settings. However, this bundle has not yet been studied in Asia. Our study sought to evaluate the perceptions of healthcare providers about the implementation of the FAST-M intervention in Pakistan.
    Materials and methods: The study was conducted at a public sector hospital in Hyderabad. We conducted three focus group discussions with healthcare providers including doctors, nurses, and healthcare administrators (n = 22) who implemented the FAST-M intervention. The Consolidated Framework for Implementation Research was used as a guiding framework for data collection and analysis. The data were analyzed using a thematic analysis approach and deductive methods.
    Results: Five overarching themes emerged: (I) FAST-M intervention and its significance including HCPs believing in the advantages of using the intervention to improve clinical practices; (II) Influence of outer and inner settings including non-availability of resources in the facility for sepsis care; (III) HCPs perceptions about sustainability, which were positive (IV) Integration into the clinical setting including HCPs views on the existing gaps, for example, shortage of HCPs and communication gaps, and their recommendations to improve these; and (V) Outcomes of the intervention including improved clinical processes and outcomes using the FAST-M intervention. Significant improvement in patient monitoring and FAST-M bundle completion within an hour of diagnosis of sepsis was reported by the HCPs.
    Conclusions: The healthcare providers' views were positive about the intervention, its outcomes, and long-term sustainability. The qualitative data provided findings on the acceptability of the overall implementation processes to support subsequent scaling up of the intervention.
    MeSH term(s) Humans ; Pregnancy ; Female ; Pakistan ; Qualitative Research ; Pregnancy Complications, Infectious ; Focus Groups ; Health Personnel ; Pre-Eclampsia
    Language English
    Publishing date 2023-04-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0284530
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Early recognition and management of maternal sepsis in Pakistan: a feasibility study of the implementation of FAST-M intervention.

    Ahmed, Sheikh Irfan / Rind, Ghulam Kubra / Sikandar, Raheel / Raza, Amir / Khowaja, Bakhtawar M Hanif / Parveen, Fahmida / Khan, Sehrish / Memon, Nazia / Jahangir, Arshia / Mirza, Daayl Naim / Cheshire, James / Dunlop, Catherine Louise / Shakoor, Sadia / Barolia, Rubina / Sheikh, Lumaan / Saleem, Sarah / Coomarasamy, Arri / Lissauer, David

    BMJ open

    2023  Volume 13, Issue 7, Page(s) e069135

    Abstract: Objective: Maternal sepsis is the third leading cause of maternal mortality globally. WHO and collaborators developed a care bundle called FAST-M (: Design and setting: A feasibility study with before and after design was conducted in women with ... ...

    Abstract Objective: Maternal sepsis is the third leading cause of maternal mortality globally. WHO and collaborators developed a care bundle called FAST-M (
    Design and setting: A feasibility study with before and after design was conducted in women with suspected maternal sepsis admitted at the Liaquat University of Medical and Health Sciences hospital Hyderabad. The study outcomes were compared between baseline and intervention phases. In the baseline phase (2 months), the existing sepsis care practices were recorded, followed by a training programme for healthcare providers on the application of FAST-M tools. These tools were implemented in the intervention phase (4 months) to assess any change in clinical practices compared with the baseline phase.
    Results: During the FAST-M implementation, 439 women were included in the study. 242/439 were suspected maternal infection cases, and 138/242 were women with suspected maternal sepsis. The FAST-M bundle was implemented in women with suspected maternal sepsis. Following the FAST-M intervention, significant changes were observed. Improvements were seen in the monitoring of oxygen saturation measurements (25.5% vs 100%; difference: 74%; 95% CI: 68.4% to 80.5%; p<0.01), fetal heart rate assessment (58% vs 100%; difference: 42.0%; 95% CI: 33.7% to 50.3%; p≤0.01) and measurement of urine output (76.5% vs 100%; difference: 23.5%; 95% CI: 17.6% to 29.4%; p<0.01). Women with suspected maternal sepsis received all components of the treatment bundle within 1 hour of sepsis recognition (0% vs 70.5%; difference: 70.5%; 95% CI: 60.4% to 80.6%; p<0.01).
    Conclusion: Implementation of the FAST-M intervention was considered feasible and enhanced early identification and management of maternal sepsis at the study site.
    Trial registration number: ISRCTN17105658.
    MeSH term(s) Female ; Humans ; Pregnancy ; Anti-Bacterial Agents/therapeutic use ; Feasibility Studies ; Pakistan ; Pregnancy Complications, Infectious/diagnosis ; Sepsis/diagnosis ; Sepsis/therapy ; Sepsis/etiology
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2023-07-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-069135
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Adapting the FAST-M maternal sepsis intervention for implementation in Pakistan: a qualitative exploratory study.

    Ahmed, Sheikh Irfan / Khowaja, Bakhtawar M Hanif / Barolia, Rubina / Sikandar, Raheel / Rind, Ghulam Kubra / Khan, Sehrish / Rani, Raheela / Cheshire, James / Dunlop, Catherine Louise / Coomarasamy, Arri / Sheikh, Lumaan / Lissauer, David

    BMJ open

    2022  Volume 12, Issue 9, Page(s) e059273

    Abstract: Objective: A maternal sepsis management bundle for resource-limited settings was developed through a synthesis of evidence and international consensus. This bundle, called 'FAST-M' consists of: Fluids, Antibiotics, Source control, assessment of the need ...

    Abstract Objective: A maternal sepsis management bundle for resource-limited settings was developed through a synthesis of evidence and international consensus. This bundle, called 'FAST-M' consists of: Fluids, Antibiotics, Source control, assessment of the need to Transport/Transfer to a higher level of care and ongoing Monitoring (of the mother and neonate). The study aimed to adapt the FAST-M intervention including the bundle care tools for early identification and management of maternal sepsis in a low-resource setting of Pakistan and identify potential facilitators and barriers to its implementation.
    Setting: The study was conducted at the Liaquat University of Medical and Health Sciences, which is a tertiary referral public sector hospital in Hyderabad.
    Design and participants: A qualitative exploratory study comprising key informant interviews and a focus group discussion was conducted with healthcare providers (HCPs) working in the study setting between November 2020 and January 2021, to ascertain the potential facilitators and barriers to the implementation of the FAST-M intervention. Interview guides were developed using the five domains of the Consolidated Framework for Implementation Research: intervention characteristics, outer setting, inner setting, characteristics of the individuals and process of implementation.
    Results: Four overarching themes were identified, the hindering factors for implementation of the FAST-M intervention were: (1) Challenges in existing system such as a shortage of resources and lack of quality assurance; and (2) Clinical practice variation that includes lack of sepsis guidelines and documentation; the facilitating factors identified were: (3) HCPs' perceptions about the FAST-M intervention and their positive views about its execution and (4) Development of HCPs readiness for FAST-M implementation that aided in identifying solutions to potential hindering factors at their clinical setting.
    Conclusion: The study has identified potential gaps and probable solutions to the implementation of the FAST-M intervention, with modifications for adaptation in the local context TRIAL REGISTRATION NUMBER: ISRCTN17105658.
    MeSH term(s) Pregnancy ; Female ; Infant, Newborn ; Humans ; Pakistan ; Qualitative Research ; Focus Groups ; Health Personnel ; Pregnancy Complications, Infectious
    Language English
    Publishing date 2022-09-09
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-059273
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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