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Viruses 2019, 11(2), 194; https://doi.org/10.3390/v11020194

Priorities, Barriers, and Facilitators towards International Guidelines for the Delivery of Supportive Clinical Care during an Ebola Outbreak: A Cross-Sectional Survey

1
Centre de recherche du CHUS de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
2
Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC J1H-5N4, Canada
3
Centre de recherche, Hôpital Charles-Le Moyne, Longueuil, QC J4V 2H1, Canada
4
Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5H3, Canada
5
Western University, School of Health Studies, London, ON N6A 3K7, Canada
6
Department of Paediatrics, University of British Columbia, Vancouver, BC V6H 3N1, Canada
7
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
8
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
9
Clinical Research Unit, Research Center, Sainte-Justine Hospital, Université de Montréal, Montréal, QC H3S 2G4, Canada
10
Outbreak Diseases Research Group, University of Oxford, Wellcome Trust Centre for Human Genetics, Oxford OX3 7BN, UK
11
Division of Infectious Diseases, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada
12
Dignitas International, Zomba P.O. Box 1071, Malawi
13
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, ON M5S 1J4, Canada
14
Division of Global Health, University of British Columbia, Vancouver, BC V6T-1Z3, Canada
15
School of Population and Public Health, University of British Columbia, Vancouver, BC V6T-1Z3, Canada
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Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
17
Department of Medicine, Division of Critical Care Medicine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
*
Author to whom correspondence should be addressed.
Received: 29 January 2019 / Revised: 18 February 2019 / Accepted: 20 February 2019 / Published: 23 February 2019
(This article belongs to the Special Issue Medical Advances in Viral Hemorrhagic Fever Research)
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Abstract

During the Ebola outbreak, mortality reduction was attributed to multiple improvements in supportive care delivered in Ebola treatment units (ETUs). We aimed to identify high-priority supportive care measures, as well as perceived barriers and facilitators to their implementation, for patients with Ebola Virus Disease (EVD). We conducted a cross-sectional survey of key stakeholders involved in the response to the 2014–2016 West African EVD outbreak. Out of 57 email invitations, 44 responses were received, and 29 respondents completed the survey. The respondents listed insufficient numbers of health workers (23/29, 79%), improper tools for the documentation of clinical data (n = 22/28, 79%), insufficient material resources (n = 22/29, 76%), and unadapted personal protective equipment (n = 20/28, 71%) as the main barriers to the provision of supportive care in ETUs. Facilitators to the provision of supportive care included team camaraderie (n in agreement = 25/28, 89%), ability to speak the local language (22/28, 79%), and having treatment protocols in place (22/28, 79%). This survey highlights a consensus across various stakeholders involved in the response to the 2014–2016 EVD outbreak on a limited number of high-priority supportive care interventions for clinical practice guidelines. Identified barriers and facilitators further inform the application of guidelines. View Full-Text
Keywords: survey; supportive care; priorities; barriers and facilitators; Ebola Virus Disease survey; supportive care; priorities; barriers and facilitators; Ebola Virus Disease
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Battista, M.-C.; Loignon, C.; Benhadj, L.; Nouvet, E.; Murthy, S.; Fowler, R.; Adhikari, N.K.J.; Haj-Moustafa, A.; Salam, A.P.; Chan, A.K.; Mishra, S.; Couturier, F.; Hudon, C.; Horby, P.; Bedell, R.; Rekart, M.; Hajek, J.; Lamontagne, F. Priorities, Barriers, and Facilitators towards International Guidelines for the Delivery of Supportive Clinical Care during an Ebola Outbreak: A Cross-Sectional Survey. Viruses 2019, 11, 194.

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