Development of the FAST-M maternal sepsis care bundle for use in low resource settings: a modified Delphi process.

Lissauer, David, Cheshire, James, Dunlop, Catherine, Taki, Fatima, Wilson, Amie, Smith, Jeffrey Michael, Daniels, Ron, Kissoon, Niranjan, Malata, Address, Chirwa, Thomson, Lwesha, Victoria Mayamingie, Mhango, Chisale, Mhango, Edward, Makwenda, Charles, Banda, Lumbani, Munthali, Laura, Nambiar, Bejoy, Hussein, Julia, Williams, Helen Marie, Devall, Adam James, Gallos, Ioannis, Merriel, Abi, Bonet, Mercedes, Souza, Joao Paulo and Coomarasamy, Arri (2019) Development of the FAST-M maternal sepsis care bundle for use in low resource settings: a modified Delphi process. BJOG : an international journal of obstetrics and gynaecology. ISSN 1471-0528. This article is available to all UHB staff and students login using a UHB Athens Account. Register for Athens here - https://openathens.nice.org.uk/

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Abstract

OBJECTIVE

To develop a sepsis care bundle for the initial management of maternal sepsis in low resource settings.

DESIGN

Modified Delphi process.

SETTING

Participants from 34 countries.

POPULATION

Healthcare practitioners working in low resource settings (n=143; 34 countries), members of an expert panel (n=11) and consultation with the World Health Organization Global Maternal and Neonatal Sepsis Initiative technical working group.

METHODS

We reviewed the literature to identify all potential interventions and practices around the initial management of sepsis that could be bundled together. A modified Delphi process, using an online questionnaire and in-person meetings, was then undertaken to gain consensus on bundle items. Participants ranked potential bundle items in terms of perceived importance and feasibility, considering its use in both hospitals and health centres. Findings from the healthcare practitioners were then triangulated with those of the experts.

MAIN OUTCOME MEASURE

Consensus on bundle items.

RESULTS

Consensus was reached after three consultation rounds, with the same items deemed most important and feasible by both the healthcare practitioners and expert panel. Final bundle items selected were: i) Fluids, ii) Antibiotics, iii) Source identification and control, iv) Transfer (to appropriate higher-level care) and v) Monitoring (of both mother and neonate as appropriate). The bundle was given the acronym "FAST-M".

CONCLUSION

A clinically relevant maternal sepsis care bundle for low resource settings has been developed by international consensus.

Item Type:	Article
Additional Information:	This article is available to all UHB staff and students login using a UHB Athens Account. Register for Athens here - https://openathens.nice.org.uk/
Subjects:	WB Practice of medicine > WB400 Intensive care WP Gynaecology. Women’s health WS Paediatrics. Child health
Divisions:	Womens and Childrens
Related URLs:	https://www.ncbi.nlm.nih.gov/pubmed/3167...
Depositing User:	Mr Philip O'Reilly
Date Deposited:	08 Nov 2019 14:00
Last Modified:	05 May 2022 07:25
URI:	http://www.repository.uhblibrary.co.uk/id/eprint/2565

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