Pediatric anesthesia practices, adherence to peri operative safety standards and training interventions in low resource hospital settings: a scoping review protocol

Pediatric anesthesia is a specialized area involving the administration of anesthesia to children undergoing surgical and non-surgical procedures. The complexities associated with pediatric anesthesia arise from the characteristic physiological, anatomical, and psychological differences between children and adults. In low-resource settings, including those of large parts of sub-Saharan Africa, these are compounded by inaccessibility to basic medications, essential equipment, and trained personnel. Understanding the current state of pediatric anesthesia practice in these settings is therefore important for improving patient safety and outcomes. Despite the recognition of safe pediatric anesthesia care, a large gap in literature remains with respect to adherence to safety standards, coupled with effectiveness of training interventions in low-resource settings. Most such studies have demonstrated varying adherence to established safety protocols, such as the WHO Surgical Safety Checklist, in these environments. Moreover, training programs to improve provider competency are not well implemented or evaluated, leading to variations in practice that jeopardize patient safety. Preliminary searches of existing literature suggest a growing body of evidence addressing pediatric anesthesia practices in low-resource settings. For example, studies have documented the challenges faced by healthcare providers in delivering safe anesthesia care to children. While there have been a few successful training interventions that have enhanced provider competency and adherence to safety standards. From these results, it would appear that there is sufficient evidence to meet the inclusion criteria for this scoping review. In addition, a preliminary search of MEDLINE, the Cochrane Database of Systematic Reviews and JBI Evidence Synthesis was conducted and no current or underway systematic reviews or scoping reviews on the topic were identified. The rationale for the study, therefore, is to conduct a scoping review that will systematically map the existing evidence on pediatric anesthesia practices, adherence to safety standards, and training interventions in low-resource settings. This review serves to identify knowledge and practice gaps, informs policy development, and guides future research efforts. A scoping review is thus very relevant for this topic on various fronts: it helps in the exploration of a wide area of research in which evidence is still emerging. With the variability of pediatric anesthesia practices in the various low-resource settings, this scoping review shall help in identifying key themes, knowledge gaps, and areas that require further investigation. Second, scoping reviews are useful for mapping the extent of research activity in a given field and can inform future research directions. This review synthesizes the available literature on pediatric anesthesia practices, adherence to safety standards, and training interventions and thus provides valuable insights that will help policymakers and practitioners to work in enhancing the status of pediatric anesthesia care in low-resource settings. This review will importantly contribute to our understanding of practices in pediatric anesthesia in low-resource environments. It will also help in the development of targeted interventions by highlighting what exists as evidence and what are the knowledge gaps on improving safety and quality in the provision of anesthesia care for children.