Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania
| dc.contributor.advisor | wallis, Lee A | |
| dc.contributor.advisor | Coats, Timothy | |
| dc.contributor.author | Sawe, Hendry | |
| dc.date.accessioned | 2022-03-14T05:27:49Z | |
| dc.date.available | 2022-03-14T05:27:49Z | |
| dc.date.issued | 2021 | |
| dc.date.updated | 2022-03-14T05:27:14Z | |
| dc.description.abstract | Background: Trauma registries are vital to a well-organized trauma system. However, registries are non-existent in most low and middle-income countries, largely due to the difficulty of reliably capturing patient-level data. The aim of this thesis was to develop and implement a context appropriate standardised trauma form incorporating the World Health Organization Data Set for Injury, for both clinical documentation and use in a trauma registry. Methods: This mixed methods participatory action research utilised Susman and Evered's approach to develop and implement a standardised trauma form, using its five steps: diagnosis, action planning, intervention, evaluation and specifying learning. In the diagnosis phase, an assessment of baseline documentation was performed. In the action-planning phase, focus group discussion revealed the barriers and facilitators to completing documentation. Then, in the actiontaking phase, semi structured interviews, training of health care providers, and feedback enabled the development, review, pilot, and implementation of a standardised trauma form. In the evaluation phase, we compared the number and types of variables captured after the form was implemented to the baseline collection. Finally, we specified learning to inform the next steps in the amplification of the observed impact. Results: The diagnosis phase established that many injury variables were not captured routinely at the participating regional hospitals. Analysis of barriers and facilitators and feedback on perceptions of providers toward using standardised documentation informed the development, piloting, modification, training of providers and implementation of a context appropriate standardised trauma documentation form for clinical charting and data capture. Implementation of the standardised trauma form was associated with improved capture of injury variables from baseline pre-implementation (33.6%), during 30-days initial pilot (86.4%) and after seven months post implementation (96.3%). The providers reported the form was user-friendly, resulted in less time documenting, and served as a guide to managing trauma patients. Conclusions: Through participatory action research a contextually appropriate, standardised trauma documentation form was successfully developed and implemented, yielding marked improvement in the capture of essential injury variables. This model can serve as a working guide to other low- and middle-income countries seeking to establish sustainable national injury registries. | |
| dc.identifier.apacitation | Sawe, H. (2021). <i>Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania</i>. (). ,Faculty of Health Sciences ,Division of General Surgery. Retrieved from http://hdl.handle.net/11427/36060 | en_ZA |
| dc.identifier.chicagocitation | Sawe, Hendry. <i>"Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania."</i> ., ,Faculty of Health Sciences ,Division of General Surgery, 2021. http://hdl.handle.net/11427/36060 | en_ZA |
| dc.identifier.citation | Sawe, H. 2021. Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania. . ,Faculty of Health Sciences ,Division of General Surgery. http://hdl.handle.net/11427/36060 | en_ZA |
| dc.identifier.ris | TY - Doctoral Thesis AU - Sawe, Hendry AB - Background: Trauma registries are vital to a well-organized trauma system. However, registries are non-existent in most low and middle-income countries, largely due to the difficulty of reliably capturing patient-level data. The aim of this thesis was to develop and implement a context appropriate standardised trauma form incorporating the World Health Organization Data Set for Injury, for both clinical documentation and use in a trauma registry. Methods: This mixed methods participatory action research utilised Susman and Evered's approach to develop and implement a standardised trauma form, using its five steps: diagnosis, action planning, intervention, evaluation and specifying learning. In the diagnosis phase, an assessment of baseline documentation was performed. In the action-planning phase, focus group discussion revealed the barriers and facilitators to completing documentation. Then, in the actiontaking phase, semi structured interviews, training of health care providers, and feedback enabled the development, review, pilot, and implementation of a standardised trauma form. In the evaluation phase, we compared the number and types of variables captured after the form was implemented to the baseline collection. Finally, we specified learning to inform the next steps in the amplification of the observed impact. Results: The diagnosis phase established that many injury variables were not captured routinely at the participating regional hospitals. Analysis of barriers and facilitators and feedback on perceptions of providers toward using standardised documentation informed the development, piloting, modification, training of providers and implementation of a context appropriate standardised trauma documentation form for clinical charting and data capture. Implementation of the standardised trauma form was associated with improved capture of injury variables from baseline pre-implementation (33.6%), during 30-days initial pilot (86.4%) and after seven months post implementation (96.3%). The providers reported the form was user-friendly, resulted in less time documenting, and served as a guide to managing trauma patients. Conclusions: Through participatory action research a contextually appropriate, standardised trauma documentation form was successfully developed and implemented, yielding marked improvement in the capture of essential injury variables. This model can serve as a working guide to other low- and middle-income countries seeking to establish sustainable national injury registries. DA - 2021 DB - OpenUCT DP - University of Cape Town KW - General Surgery LK - https://open.uct.ac.za PY - 2021 T1 - Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania TI - Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania UR - http://hdl.handle.net/11427/36060 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/36060 | |
| dc.identifier.vancouvercitation | Sawe H. Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania. []. ,Faculty of Health Sciences ,Division of General Surgery, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36060 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Division of General Surgery | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | General Surgery | |
| dc.title | Building a model for development of a national trauma registry: designing and implementing standardised trauma form at regional hospitals in Tanzania | |
| dc.type | Doctoral Thesis | |
| dc.type.qualificationlevel | Doctoral | |
| dc.type.qualificationlevel | PhD |