Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian's model
Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Deaths due to pesticide poisoning can be reduced if poisoning cases are managed optimally. However, the quality of care given to pesticide poisoning patients is still insufficien...
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| creator | Ssemugabo, Charles Nalinya, Sarah Halage, Abdullah Ali Neebye, Ruth Mubeezi Musoke, David Jørs, Erik |
| description | Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Deaths due to pesticide poisoning can be reduced if poisoning cases are managed optimally. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. This study was aimed at exploring doctors' experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda.
Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent to ensuring quality of care.
Doctors reported structural, process and outcome facets that support diagnosis and treatment of pesticide poisoning cases that improved the quality of care they provided. Among the structures includes hospital units such as Intensive Care Unit (ICU), pediatrics and internal medicine; equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors' knowledge and experiences. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases whether or not relevant to treat the actual pesticide active ingredient responsible for the poisoning. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients.
Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance in improving management of pesticide poisoning cases in hospitals in Kampala, Uganda. |
| doi_str_mv | 10.1186/s12913-020-4891-6 |
| format | Article |
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Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent to ensuring quality of care.
Doctors reported structural, process and outcome facets that support diagnosis and treatment of pesticide poisoning cases that improved the quality of care they provided. Among the structures includes hospital units such as Intensive Care Unit (ICU), pediatrics and internal medicine; equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors' knowledge and experiences. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases whether or not relevant to treat the actual pesticide active ingredient responsible for the poisoning. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients.
Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance in improving management of pesticide poisoning cases in hospitals in Kampala, Uganda.</description><identifier>ISSN: 1472-6963</identifier><identifier>EISSN: 1472-6963</identifier><identifier>DOI: 10.1186/s12913-020-4891-6</identifier><identifier>PMID: 31918695</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Attitude of Health Personnel ; Bats ; Beliefs, opinions and attitudes ; Care and treatment ; Clinical practice guidelines ; Content analysis ; Data collection ; Female ; Health aspects ; Health services ; Hospital patients ; Hospitals ; Humans ; Intensive care ; Internal medicine ; Interviews ; Laboratories ; Male ; Medical care quality ; Medical diagnosis ; Medical personnel ; Medical referrals ; Medical Staff, Hospital - psychology ; Medical Staff, Hospital - statistics & numerical data ; Methods ; Outcome and process assessment (Medical care) ; Outcome and Process Assessment, Health Care ; Outcomes ; Patient care ; Pediatrics ; Pesticide poisoning management ; Pesticides ; Pesticides - poisoning ; Physicians ; Poisoning ; Poisoning - therapy ; Practice ; Processes ; Psychiatrists ; Public health ; Qualitative Research ; Quality ; Quality of care ; Quality of Health Care ; Signs and symptoms ; Structural ; Suicide ; Suicides & suicide attempts ; Treatment Outcome ; Uganda ; User fees ; Workers</subject><ispartof>BMC health services research, 2020-01, Vol.20 (1), p.30-8, Article 30</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-aa315b3839172f4039869ae445e8525449fb5e90f474c47ebae93bbd38456cb43</citedby><cites>FETCH-LOGICAL-c521t-aa315b3839172f4039869ae445e8525449fb5e90f474c47ebae93bbd38456cb43</cites><orcidid>0000-0001-6857-0091</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953287/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953287/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31918695$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ssemugabo, Charles</creatorcontrib><creatorcontrib>Nalinya, Sarah</creatorcontrib><creatorcontrib>Halage, Abdullah Ali</creatorcontrib><creatorcontrib>Neebye, Ruth Mubeezi</creatorcontrib><creatorcontrib>Musoke, David</creatorcontrib><creatorcontrib>Jørs, Erik</creatorcontrib><title>Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian's model</title><title>BMC health services research</title><addtitle>BMC Health Serv Res</addtitle><description>Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Deaths due to pesticide poisoning can be reduced if poisoning cases are managed optimally. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. This study was aimed at exploring doctors' experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda.
Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent to ensuring quality of care.
Doctors reported structural, process and outcome facets that support diagnosis and treatment of pesticide poisoning cases that improved the quality of care they provided. Among the structures includes hospital units such as Intensive Care Unit (ICU), pediatrics and internal medicine; equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors' knowledge and experiences. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases whether or not relevant to treat the actual pesticide active ingredient responsible for the poisoning. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients.
Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance in improving management of pesticide poisoning cases in hospitals in Kampala, Uganda.</description><subject>Attitude of Health Personnel</subject><subject>Bats</subject><subject>Beliefs, opinions and attitudes</subject><subject>Care and treatment</subject><subject>Clinical practice guidelines</subject><subject>Content analysis</subject><subject>Data collection</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health services</subject><subject>Hospital patients</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Internal medicine</subject><subject>Interviews</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical care quality</subject><subject>Medical diagnosis</subject><subject>Medical personnel</subject><subject>Medical referrals</subject><subject>Medical Staff, Hospital - psychology</subject><subject>Medical Staff, Hospital - statistics & numerical data</subject><subject>Methods</subject><subject>Outcome and process assessment (Medical care)</subject><subject>Outcome and Process Assessment, Health Care</subject><subject>Outcomes</subject><subject>Patient care</subject><subject>Pediatrics</subject><subject>Pesticide poisoning management</subject><subject>Pesticides</subject><subject>Pesticides - poisoning</subject><subject>Physicians</subject><subject>Poisoning</subject><subject>Poisoning - therapy</subject><subject>Practice</subject><subject>Processes</subject><subject>Psychiatrists</subject><subject>Public health</subject><subject>Qualitative Research</subject><subject>Quality</subject><subject>Quality of care</subject><subject>Quality of Health Care</subject><subject>Signs and symptoms</subject><subject>Structural</subject><subject>Suicide</subject><subject>Suicides & suicide attempts</subject><subject>Treatment Outcome</subject><subject>Uganda</subject><subject>User 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experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian's model</title><author>Ssemugabo, Charles ; Nalinya, Sarah ; Halage, Abdullah Ali ; Neebye, Ruth Mubeezi ; Musoke, David ; Jørs, Erik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-aa315b3839172f4039869ae445e8525449fb5e90f474c47ebae93bbd38456cb43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Attitude of Health Personnel</topic><topic>Bats</topic><topic>Beliefs, opinions and attitudes</topic><topic>Care and treatment</topic><topic>Clinical practice guidelines</topic><topic>Content analysis</topic><topic>Data collection</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health services</topic><topic>Hospital patients</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive 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Care</topic><topic>Signs and symptoms</topic><topic>Structural</topic><topic>Suicide</topic><topic>Suicides & suicide attempts</topic><topic>Treatment Outcome</topic><topic>Uganda</topic><topic>User fees</topic><topic>Workers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ssemugabo, Charles</creatorcontrib><creatorcontrib>Nalinya, Sarah</creatorcontrib><creatorcontrib>Halage, Abdullah Ali</creatorcontrib><creatorcontrib>Neebye, Ruth Mubeezi</creatorcontrib><creatorcontrib>Musoke, David</creatorcontrib><creatorcontrib>Jørs, Erik</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ABI/INFORM 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David</au><au>Jørs, Erik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian's model</atitle><jtitle>BMC health services research</jtitle><addtitle>BMC Health Serv Res</addtitle><date>2020-01-09</date><risdate>2020</risdate><volume>20</volume><issue>1</issue><spage>30</spage><epage>8</epage><pages>30-8</pages><artnum>30</artnum><issn>1472-6963</issn><eissn>1472-6963</eissn><abstract>Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Deaths due to pesticide poisoning can be reduced if poisoning cases are managed optimally. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. This study was aimed at exploring doctors' experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda.
Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent to ensuring quality of care.
Doctors reported structural, process and outcome facets that support diagnosis and treatment of pesticide poisoning cases that improved the quality of care they provided. Among the structures includes hospital units such as Intensive Care Unit (ICU), pediatrics and internal medicine; equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors' knowledge and experiences. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases whether or not relevant to treat the actual pesticide active ingredient responsible for the poisoning. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients.
Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance in improving management of pesticide poisoning cases in hospitals in Kampala, Uganda.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>31918695</pmid><doi>10.1186/s12913-020-4891-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6857-0091</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Attitude of Health Personnel Bats Beliefs, opinions and attitudes Care and treatment Clinical practice guidelines Content analysis Data collection Female Health aspects Health services Hospital patients Hospitals Humans Intensive care Internal medicine Interviews Laboratories Male Medical care quality Medical diagnosis Medical personnel Medical referrals Medical Staff, Hospital - psychology Medical Staff, Hospital - statistics & numerical data Methods Outcome and process assessment (Medical care) Outcome and Process Assessment, Health Care Outcomes Patient care Pediatrics Pesticide poisoning management Pesticides Pesticides - poisoning Physicians Poisoning Poisoning - therapy Practice Processes Psychiatrists Public health Qualitative Research Quality Quality of care Quality of Health Care Signs and symptoms Structural Suicide Suicides & suicide attempts Treatment Outcome Uganda User fees Workers |
| title | Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian's model |
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