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

Ahmed, Sheikh Irfan ORCID: 0000-0002-8391-8559, Khowaja, Bakhtawar M Hanif, Barolia, Rubina, Sikandar, Raheel, Rind, Ghulam Kubra, Khan, Sehrish, Rani, Raheela, Cheshire, James ORCID: 0000-0002-0967-7320, Dunlop, Catherine Louise ORCID: 0000-0002-4792-9496, Coomarasamy, Arri
et al (show 2 more authors) (2022) Adapting the FAST-M maternal sepsis intervention for implementation in Pakistan: a qualitative exploratory study. BMJ open, 12 (9). e059273-.

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<h4>Objective</h4>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.<h4>Setting</h4>The study was conducted at the Liaquat University of Medical and Health Sciences, which is a tertiary referral public sector hospital in Hyderabad.<h4>Design and participants</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.

Item Type: Article
Uncontrolled Keywords: Humans, Pregnancy Complications, Infectious, Focus Groups, Pregnancy, Qualitative Research, Infant, Newborn, Health Personnel, Pakistan, Female
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 01 Feb 2023 11:08
Last Modified: 26 Nov 2023 13:09
DOI: 10.1136/bmjopen-2021-059273
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