Implementation of an in- XXXX pediatric mortality reduction intervention, Gondar University Hospital, Ethiopia.

@entity1 @entity410 @entity295 @entity2700 @entity712 @entity649 @entity772 @entity204 @entity1224
SETTING: Gondar University Hospital (GUH) is a resource-limited tertiary care hospital in northern Ethiopia. OBJECTIVE: To evaluate the aggregate effect of care standardization, institutional guidelines, and simulation-based training on pediatric mortality at a resource-limited hospital. DESIGN: Uncontrolled pre-post study. GUH in- @entity1 aged from 30 days to 14 years were included in the program evaluation (baseline 11 September-18 November 2010; intervention 19 September-9 December 2011). Interns attached to the GUH pediatrics department from 6 September to 9 December 2011 were included in the training evaluation. Institution-specific management guidelines were prepared for @entity1224 , @entity649 , @entity2700 , @entity295 , @entity712 , @entity772 , and @entity410 . Approval for the protocols was obtained from each pediatric faculty member. Interns received a 3.5 h simulation-based training in triage, procedural skills, and protocol usage. Primary outcome was overall @entity204 (%); secondary outcomes were @entity204 within 24 h of admission (%) and median pre/post-training emergency management test scores (%). RESULTS: No difference in mortality (OR 0.72, 95%CI 0.40-1.29, P = 0.265) or first 24 h mortality (crude OR 0.97, 95%CI 0.37-2.55) was observed. Trainee examination scores improved from 33% to 74% (P < 0.001). CONCLUSION: Combining care standardization, management protocols, and simulation-based training did not reduce mortality among pediatric in- @entity1 . Focused, simulation-based training improved short-term test scores among interns.
