Abstract
In response to acute strains on the health service in the aftermath of the West African Ebola epidemic of 2014–2015, the Sierra Leone Ministry of Health and Sanitation (MoHS) developed a nurse-led model of emergency paediatric care based on the World Health Organisation (WHO)-validated Emergency Triage Assessment and Treatment+ (ETAT+) framework. Implementation of the ETAT+ standards involved process change and the creation of enabling environments for emergency paediatric care in addition to a programme of teaching and assessment for nurses working on the paediatric ward in every government hospital. The first year of implementation led to improvements across all pre-specified markers of care quality and a decrease in overall mortality. Follow-up of mortality rates in the second year of implementation showed marked differences in mortality trends at individual hospitals, suggesting that context-specific factors influenced the success of implementation in different facilities. The factors that were likely to have affected implementation included medical and nursing leadership within the hospital; rotation of ETAT-trained nurses away from the paediatric ward; disruptions to the supply of essential utilities, equipment, and medication, which affected the ability to deliver ETAT+ interventions and affected nursing morale. The programme demonstrates that first-line emergency paediatric care can safely and effectively be undertaken by nursing staff in Sierra Leone and that ETAT+ can serve as a framework for nurse-led structured quality improvement work across clinical processes, environment, and practice.
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Hands, C., Hands, S., Bangura, J., Sankoh, K. (2023). The Sierra Leone National ETAT+ Programme: Delivering Nurse-Led Emergency Paediatric Care. In: Betz, C.L. (eds) Worldwide Successful Pediatric Nurse-Led Models of Care. Springer, Cham. https://doi.org/10.1007/978-3-031-22152-1_10
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DOI: https://doi.org/10.1007/978-3-031-22152-1_10
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