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

Show full item record



Permalink

http://hdl.handle.net/10138/326339

Citation

Stassen , W , Kurland , L , Wallis , L , Castren , M & Vincent-Lambert , C 2020 , ' Barriers and facilitators to implementing coronary care networks in South Africa : a qualitative study ' , African Health Sciences , vol. 20 , no. 1 , pp. 338-350 . https://doi.org/10.4314/ahs.v20i1.39

Title: Barriers and facilitators to implementing coronary care networks in South Africa : a qualitative study
Author: Stassen, Willem; Kurland, Lisa; Wallis, Lee; Castren, Maaret; Vincent-Lambert, Craig
Other contributor: University of Helsinki, HUS Emergency Medicine and Services


Date: 2020-03
Language: eng
Number of pages: 13
Belongs to series: African Health Sciences
ISSN: 1680-6905
DOI: https://doi.org/10.4314/ahs.v20i1.39
URI: http://hdl.handle.net/10138/326339
Abstract: 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.
Subject: Health care system
emergency care
cardiovascular disease
ACUTE MYOCARDIAL-INFARCTION
ST-SEGMENT-ELEVATION
INTERHOSPITAL TRANSFER
TIME
MANAGEMENT
MORTALITY
OUTCOMES
DELAY
3126 Surgery, anesthesiology, intensive care, radiology
3121 Internal medicine
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
195037_Article_Text_493128_1_10_20200422.pdf 376.2Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record