Using mobile health technology and community health workers to identify and refer caesarean-related surgical site infections in rural Rwanda: a randomised controlled trial protocol.
Using mobile health technology and community health workers to identify and refer caesarean-related surgical site infections in rural Rwanda: a randomised controlled trial protocol.
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使用移动医疗技术和社区卫生工作者来识别和转介卢旺达农村地区与剖腹产相关的手术部位感染：一项随机对照试验方案。
DOI：
10.1136/bmjopen-2018-022214
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发表时间：
2018
期刊：
影响因子：
2.9
通讯作者：
Hedt-Gauthier,BethanyL
中科院分区：
文献类型：
--
作者：
Sonderman,KristinA;Nkurunziza,Theoneste;Kateera,Fredrick;Gruendl,Magdalena;Koch,Rachel;Gaju,Erick;Habiyakare,Caste;Matousek,Alexi;Nahimana,Evrard;Ntakiyiruta,Georges;Riviello,Robert;Hedt-Gauthier,BethanyL
引言手术部位感染（SSIs）是低收入和中等收入国家发病率和死亡率的重要原因，这些国家的SSIs率可达30%。由于入路受限，术后随访极少。在大多数情况下，社区卫生工作者（CHW）尚未用于手术患者。电信的进步为移动的健康工具支持社区卫生工作者创造了机会。我们的目标是评估使用移动医疗技术，以帮助CHW在识别SSI和促进转诊的病人回到healthcare facilities.Methods and analysisProspective randomized controlled trial carried at Kirehe District Hospital，Rwanda，from November 2017 to November 2018.年龄≥18岁且接受剖腹产手术的患者符合资格。非Kirehe区居民或术后住院超过10天的患者将被排除在外。患者将被随机分配至三个组之一。对于第1组，CHW将在术后第10天（±3天）访视患者家中，使用电子平板电脑执行SSI筛查方案（发热、疼痛或脓性引流）。对于组2，CHW将通过电话实施筛选方案。对于第1组和第2组，CHW将把对任何问题回答“是”的患者转诊至医疗机构。对于组3，患者将不接受随访护理。我们的主要结果将是mHealth-CHW干预对SSI.Ethics和disseminationThe研究的患者的护理回报率的影响已获得卢旺达国家伦理委员会和合作伙伴医疗的伦理批准。结果将通过会议和同行评议出版物传播给Kirehe地区医院、卢旺达卫生部、卢旺达外科学会、健康伙伴组织。试验注册号NCT 03311399。
IntroductionSurgical site infections (SSIs) are a significant cause of morbidity and mortality in low-income and middle-income countries, where rates of SSIs can reach 30%. Due to limited access, there is minimal follow-up postoperatively. Community health workers (CHWs) have not yet been used for surgical patients in most settings. Advancements in telecommunication create an opportunity for mobile health (mHealth) tools to support CHWs. We aim to evaluate the use of mHealth technology to aid CHWs in identification of SSIs and promote referral of patients back to healthcare facilities.Methods and analysisProspective randomised controlled trial conducted at Kirehe District Hospital, Rwanda, from November 2017 to November 2018. Patients ≥18 years who undergo caesarean section are eligible. Non-residents of Kirehe District or patients who remain in hospital >10 days postoperatively will be excluded. Patients will be randomised to one of three arms. For arm 1, a CHW will visit the patient’s home on postoperative day 10 (±3 days) to administer an SSI screening protocol (fever, pain or purulent drainage) using an electronic tablet. For arm 2, the CHW will administer the screening protocol over the phone. For both arms 1 and 2, the CHW will refer patients who respond ‘yes’ to any of the questions to a health facility. For arm 3, patients will not receive follow-up care. Our primary outcome will be the impact of the mHealth-CHW intervention on the rate of return to care for patients with an SSI.Ethics and disseminationThe study has received ethical approval from the Rwandan National Ethics Committee and Partners Healthcare. Results will be disseminated to Kirehe District Hospital, Rwanda Ministry of Health, Rwanda Surgical Society, Partners In Health, through conferences and peer-reviewed publications.Trial registration numberNCT03311399.
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