The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings

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dc.contributor.authorNathan, Hannah L
dc.contributor.authorBoene, Helena
dc.contributor.authorMunguambe, Khatia
dc.contributor.authorSevene, Esperança
dc.contributor.authorAkeju, David
dc.contributor.authorAdetoro, Olalekan O
dc.contributor.authorCharanthimath, Umesh
dc.contributor.authorBellad, Mrutyunjaya B
dc.contributor.authorde Greeff, Annemarie
dc.contributor.authorAnthony, John
dc.contributor.authorHall, David R
dc.contributor.authorSteyn, Wilhelm
dc.contributor.authorVidler, Marianne
dc.contributor.authorvon Dadelszen, Peter
dc.contributor.authorChappell, Lucy C
dc.contributor.authorSandall, Jane
dc.contributor.authorShennan, Andrew H
dc.date.accessioned2018-01-09T09:16:50Z
dc.date.available2018-01-09T09:16:50Z
dc.date.issued2018-01-05
dc.date.updated2018-01-07T04:14:55Z
dc.description.abstractBackground: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device. Methods: Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach. Results: Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device’s accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period. Conclusion: The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral.
dc.identifier.apacitationNathan, H. L., Boene, H., Munguambe, K., Sevene, E., Akeju, D., Adetoro, O. O., ... Shennan, A. H. (2018). The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings. <i>Reproductive Health</i>, http://hdl.handle.net/11427/26774en_ZA
dc.identifier.chicagocitationNathan, Hannah L, Helena Boene, Khatia Munguambe, Esperança Sevene, David Akeju, Olalekan O Adetoro, Umesh Charanthimath, et al "The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings." <i>Reproductive Health</i> (2018) http://hdl.handle.net/11427/26774en_ZA
dc.identifier.citationNathan, H. L., Boene, H., Munguambe, K., Sevene, E., Akeju, D., Adetoro, O. O., ... & Hall, D. R. (2018). The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings. Reproductive Health, 15(1), 5.
dc.identifier.ris TY - Journal Article AU - Nathan, Hannah L AU - Boene, Helena AU - Munguambe, Khatia AU - Sevene, Esperança AU - Akeju, David AU - Adetoro, Olalekan O AU - Charanthimath, Umesh AU - Bellad, Mrutyunjaya B AU - de Greeff, Annemarie AU - Anthony, John AU - Hall, David R AU - Steyn, Wilhelm AU - Vidler, Marianne AU - von Dadelszen, Peter AU - Chappell, Lucy C AU - Sandall, Jane AU - Shennan, Andrew H AB - Background: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device. Methods: Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach. Results: Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device’s accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period. Conclusion: The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral. DA - 2018-01-05 DB - OpenUCT DO - 10.1186/s12978-017-0450-y DP - University of Cape Town J1 - Reproductive Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings TI - The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings UR - http://hdl.handle.net/11427/26774 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12978-017-0450-y
dc.identifier.urihttp://hdl.handle.net/11427/26774
dc.identifier.vancouvercitationNathan HL, Boene H, Munguambe K, Sevene E, Akeju D, Adetoro OO, et al. The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings. Reproductive Health. 2018; http://hdl.handle.net/11427/26774.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceReproductive Health
dc.source.urihttps://reproductive-health-journal.biomedcentral.com/
dc.subject.otherPregnancy
dc.subject.otherBlood pressure
dc.subject.otherVital signs
dc.subject.otherEarly warning system
dc.subject.otherAccuracy
dc.subject.otherPre-eclampsia
dc.subject.otherHaemorrhage
dc.subject.otherSepsis
dc.subject.otherQualitative methods
dc.subject.otherLow- and middle-income countries
dc.titleThe CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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