Evidence map›Paper›PMID 32912138›Full record

ArticleBMC pediatrics2020

Healthcare worker perceptions of the implementation context surrounding an infection prevention intervention in a Zambian neonatal intensive care unit.

Carter Cowden, Lawrence Mwananyanda, Davidson H Hamer, Susan E Coffin, Monica L Kapasa, Sylvia Machona, Julia E Szymczak

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Carter CowdenCenter for Pediatric Clinical Effectiveness and Division of Infectious Diseases Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Lawrence MwananyandaRight to Care Zambia, Lusaka, Zambia.
Davidson H HamerDepartment of Global Health, Boston University School of Public Health and Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Susan E CoffinCenter for Pediatric Clinical Effectiveness and Division of Infectious Diseases Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Monica L KapasaDepartment of Pediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia.
Sylvia MachonaDepartment of Pediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia.
Julia E SzymczakDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Blockley Hall Room 708, 423 Guardian Drive, Philadelphia, PA, 19104-4302, USA. jszymcza@pennmedicine.upenn.edu.ORCID 0000-0002-3230-8670
Boston University · USChildren's Hospital of Philadelphia · USUniversity Teaching Hospital · ZMUniversity of Pennsylvania · US

Funding

Thrasher Research Fund 12036
6 · The paper itself

Abstract

backgroundInfants in the neonatal intensive care unit (NICU) are particularly susceptible to healthcare-associated infections (HAIs). NICUs in low- and middle income countries face additional challenges to HAI prevention. There is a need to better understand the role of the implementation context surrounding infection prevention interventions in low- and middle income countries.

aimThe aim of this study was to identify NICU healthcare worker perceptions of an intervention to reduce bloodstream infections in a large Zambian NICU.

methodsSemi-structured interviews were conducted with NICU staff during a prospective cohort study examining the impact of an infection prevention bundle on bloodstream infections. Interviews were analyzed using an integrated approach, combining inductive theme generation with an application of the Consolidated Framework for Implementation Research (CFIR).

resultsInterviews were conducted with 17 NICU staff (5 physicians and 12 nurses). Respondents believed the bundle elements were easy to use, well-designed and facilitated improved performance. Four organizational characteristics that facilitated HAI transmission were identified - (1) lack of NICU admission protocols; (2) physical crowding; (3) understaffing; and (4) equipment shortages. Respondents suggested that NICU resource constraints reflected a societal ethos that devalued the medical care of infants. Despite the challenges, respondents were highly motivated to prevent HAIs and believed this was an achievable goal. They enthusiastically welcomed the bundle but expressed serious concern about sustainability following the study.

conclusionsBy eliciting healthcare worker perceptions about the context surrounding an infection prevention intervention, our study identified key organizational and societal factors to inform implementation strategies to achieve sustained improvement.

Indexed as

Cross InfectionIntensive Care Units, NeonatalHealth PersonnelHumansInfantInfant, NewbornPerceptionProspective StudiesBloodstream infectionsImplementation scienceInfection preventionIntensive carePediatricsQualitative methodologyZambia

Identifiers

PMID32912138
PMCPMC7488390
OpenAlexW3084386510

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.