Illustrative quotes related to proposed features and format of an ideal paediatric sepsis CDS tool
| Subthemes | Participant quote |
| Ease of use and affordability of the tool | ‘It [a CDS tool] has to be an easy tool, affordable, low cost, in order for it to be implemented in the great periphery units, where, as I told you before, there aren’t many resources. Another thing is that all staff, both technical and—because sometimes triage is done by a technician in the nurse station. It’s true, we may know a lot about scores, about early detection, but many of them don’t know anything about it, about the alarm signs in those patients. I think that’s the heart of the matter. To be able to implement all these tools, but tools that are affordable and understandable for them; as well as to the periphery.’ (Clinician, Latin America) |
| Risk stratification functionality: sensitivity vs specificity | ‘I think the tools should do both. There’s risk stratification, as well as management of the patient, because risk stratification helps us to make some bigger decisions, including referral in situations where you think the facility’s not able to manage in this case. I know this patient is going to require a tube inside the throat to survive later down the road. I don’t have the capacity to ventilate this child here, so I might as well as give this medicine and refer the patient. You can only make that decision if you risk stratify the patient. It might be too late if you don’t do the risk stratification for the patients to require that tube and you don’t have the tube. I think you should do both.’(Administrator, Africa) |
| Focus on clinical assessment rather than laboratory data | ‘I think if we are looking at the things that should be in any tool for sepsis identification and management, and again based on my experience, I think it has to be huge or large on clinical presentations. Our colleagues, at least, in Nigeria, and I would also imagine in other states, have very good solid clinical methods. They take excellent histories and do very good physical exams. Any management of sepsis, so identification of sepsis, that would have to be based on what the search criteria says might not suffice much if you want to base them on labs. One is that these—some of these patients do not have the money to pay, the labs are delayed for you to get your results. If you focus most of the tools on what people could just do right at the point of seeing this patient and starting them on treatment, I think that we’re gonna go a long way in identifying these kids and starting prompt treatment.’(Clinician, Africa) |
CDS, clinical decision support.