Clinicians’ adherence to national pneumonia management guidelines at Kitale County Hospital, Kenya

Abstract

Objectives: To determine adherence to national pneumonia guidelines in children aged 2-59 months admitted at Kitale County Hospital.

Design: Retrospective

Setting: Pediatric wards of Kitale County hospital in Trans Nzoia County, Kenya.

Participants: Children under 5 years admitted with a diagnosis of pneumonia to Kitale County Hospital Pediatric ward.

Interventions: Data were collected from the participant’s inpatient records upon discharge or death. All files were included till a sample size of 380 was achieved. Data on demographics and management was extracted from the pediatric admission form, daily ward round notes and treatment sheet. Data were then compared against the national guidelines to assess adherence.

Main outcome measures: Adherence to the guidelines.

Results: The median age was 12 months (IQR 7, 24). The males constituted 198 (52%) of the participants. The diagnosis was severe  pneumonia in 213 (56%) and pneumonia in 167 (44%) of the participants. Adherence at admission was 121 (32%) of the cases. Appropriate diagnosis was made in 202 (53%), correct drug chosen in 212 (56%) and correct dosage prescribed in 270 (71%) of the
participants. The proportion of the patients correctly managed in accordance with guidelines during the inpatient stay was 2 (0.6%). Complete adherence from admission to discharge was in 8 (2%) of the cases.

Conclusion: The level of adherence to the guidelines was low, markedly decreasing from admission to discharge.