Barriers and facilitators to implementing coronary care networks in South Africa: a qualitative study

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Stassen, WillemDepartment of Clinical Research and Education, Karolinska Institutet, Solna, Sweden; Division of Emergency Medicine, Stellenbosch University, Stellenbosch, South Africa (författare)

Barriers and facilitators to implementing coronary care networks in South Africa : a qualitative study

Artikel/kapitelEngelska2020

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2020-04-20
NISC - National Inquiry Services Centre,2020
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:oru-82931
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-82931URI
https://doi.org/10.4314/ahs.v20i1.39DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:143798376URI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:art swepub-publicationtype

Anmärkningar

Background: ST-elevation myocardial infarction (STEMI) is on the rise in sub-Saharan Africa. South Africa consistently fails to deliver timely reperfusion to these patients, possibly due to under-developed coronary care networks (CCN).Objectives: To determine the current perceived state of CCNs, to determine the barriers to optimising CCNs and to suggest facilitators to optimising CCNs within the South African context.Methods: A qualitative descriptive approach was employed, by performing two structured in-depth and two focus group interviews (n=4 and 5, respectively), inviting a purposely heterogeneous sample of 11 paramedics (n=4), doctors (n=5), and nurses (n=2) working within different settings in South African CCNs. Recorded interviews were transcribed verbatim and subjected to content analysis.Results: Participants described an under-resourced, unprioritised and fragmented CCN with significant variation in performance. Barriers to CCN optimisation resided in recognition and diagnosis of STEMI, transport and treatment decisions, and delays. Participants suggested that thrombolysing all STEMI patients could facilitate earlier reperfusion and that pre-hospital thrombolysis should be considered. Participants highlighted the need for regionalised STEMI guidelines, and the need for further research.Conclusion: Numerous barriers were highlighted. Healthcare policy-makers should prioritise the development of CCNs that is underpinned by evidence and that is contextualised to each specific region within the South African health care system.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy hsv//eng
Health care system
emergency care
cardiovascular disease

Biuppslag (personer, institutioner, konferenser, titlar ...)

Kurland, Lisa,1960-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Clinical Research and Education, Karolinska Institutet, Solna, Sweden(Swepub:oru)lkd (författare)
Wallis, LeeDivision of Emergency Medicine, Stellenbosch University, Stellenbosch, South Africa; Division of Emergency Medicine, University of Cape Town, South Africa (författare)
Castren, MaaretDepartment of Emergency Medicine and Services, Helsinki University, Helsinki, Finland (författare)
Vincent-Lambert, CraigDepartment of Emergency Medical Care, University of Johannesburg, Johannesburg, South Africa (författare)
Department of Clinical Research and Education, Karolinska Institutet, Solna, Sweden; Division of Emergency Medicine, Stellenbosch University, Stellenbosch, South AfricaInstitutionen för medicinska vetenskaper (creator_code:org_t)

Sammanhörande titlar

Ingår i:African Health Sciences: NISC - National Inquiry Services Centre20:1, s. 338-3501680-69051729-0503

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Av författaren/redakt...: Stassen, Willem; Kurland, Lisa, 1 ...; Wallis, Lee; Castren, Maaret; Vincent-Lambert, ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Hälsovetenskap; och Hälso och sjukvå ...

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Av lärosätet: Örebro universitet; Karolinska Institutet

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