The FAST-M complex intervention for the detection and management of maternal sepsis in low-resource settings: a multi-site evaluation.



Cheshire, James, Jones, Laura, Munthali, Laura, Kamphinga, Christopher, Liyaya, Harry, Phiri, Tarcizius, Parry-Smith, William, Dunlop, Catherine, Makwenda, Charles, Devall, Adam James
et al (show 8 more authors) (2021) The FAST-M complex intervention for the detection and management of maternal sepsis in low-resource settings: a multi-site evaluation. BJOG : an international journal of obstetrics and gynaecology.

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Abstract

<h4>Objective</h4>To evaluate whether the implementation of the FAST-M complex intervention was feasible and improved the recognition and management of maternal sepsis in a low-resource setting.<h4>Design</h4>A before and after design.<h4>Setting</h4>Fifteen government healthcare facilities in Malawi.<h4>Population</h4>Women suspected of having maternal sepsis.<h4>Methods</h4>The FAST-M complex intervention consisted of the following components: i) the FAST-M maternal sepsis treatment bundle and ii) the FAST-M implementation programme. Performance of selected process outcomes were compared between a two month baseline phase and six month intervention phase with compliance used as a proxy measure of feasibility.<h4>Main outcome result</h4>Compliance with vital sign recording and use of the FAST-M maternal sepsis bundle.<h4>Results</h4>Following implementation of the FAST-M intervention, women were more likely to have a complete set of vital signs taken on admission to the wards (0/163 (0%) vs. 169/252 (67.1%), p<0.001). Recognition of suspected maternal sepsis improved with more cases identified following the intervention (12/106 (11.3%) vs. 107/166 (64.5%), p<0.001). Sepsis management improved, with women more likely to receive all components of the FAST-M treatment bundle within one hour of recognition (0/12 (0%) vs. 21/107 (19.6%), p=0.091). In particular women were more likely to receive antibiotics (3/12 (25.0%) vs. 72/107 (67.3%), p=0.004) within one hour of recognition of suspected sepsis.<h4>Conclusion</h4>Implementation of the FAST-M complex intervention was feasible and led to the improved recognition and management of suspected maternal sepsis in a low-resource setting such as Malawi.

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 11 Feb 2021 08:33
Last Modified: 30 Nov 2021 08:12
DOI: 10.1111/1471-0528.16658
URI: https://livrepository.liverpool.ac.uk/id/eprint/3115464