An analysis of inter-healthcare facility transfer of neonates within the eThekwini health district of KwaZulu-Natal

Introduction Critically ill neonates often require urgent transport to a neonatal care facility shortly after birth. The safe transfer of ill neonates is a critical part of their continuum of care. Methods A review of the empirical work and literature around the safe transfer of ill neonates was undertaken to explore what factors influence a safe transfer. Results What emerged was that a multitude of adverse events influence the clinical deterioration of the neonate, including the physiological condition of the neonate, equipment-related challenges and the unpreparedness of those involved to deal with neonatal clinical emergencies. Conclusion This review highlights the necessary equipment required, the nature of clinical emergencies that may arise, and the need to consider utilising specialised neonatal transfer units to effect the safe transfer of the critically ill neonate.

Section: The Literature Reviewmentioning

confidence: 99%

Section: The Literature Reviewmentioning

confidence: 99%

Critical Issues Underpinning the Safe Transfer of Ill Neonates: A Review of the Literature

Bhagwan

2021

“…Although the team leader is ultimately responsible for the transfer, all team members should work collaboratively and understand their respective responsibilities. Ashokcoomar et al (34) and Mgcini (35) reported that preparation for the transfer of ill neonates in South Africa has been poorly executed. They suggested that once the dispatch is received by the team leader, all details regarding the neonate should become clear.…”

Section: Sub-theme 1: Salient Information Regarding the Neonate In Ad...mentioning

confidence: 99%

Towards a Safer and More Efficient Neonatal Transfer System in South Africa: A Qualitative Inquiry with Advanced Life Support Paramedics

Bhagwan

Ashokcoomar

2021

Introduction The inter-healthcare transfer of the critically ill neonate is a critical aspect of larger neonatal intensive care, as it influences the safe transport of neonates from the receiving to the referring hospital. It is crucial then that the transfer process be safe and efficient so as not to compromise the already fragile condition of the neonate. The aim of the study was to understand the challenges advanced life support (ALS) paramedics face during neonatal transfers and to understand how the process could be made safer and more efficient. The objectives related to understanding the transfer process, the challenges linked to the critically ill neonate and the difficulties associated with the ambulance vehicle and equipment. Methods Using a qualitative research approach we sought the views of ALS paramedics at the forefront of transfers nationally. In-depth interviews were held with eight paramedics in KwaZulu-Natal and four focus group discussions with ALS paramedics in KwaZulu-Natal, Gauteng, Free State and the Western Cape in South Africa. A total of 35 ALS paramedics were involved in these group discussions. Results The study uncovered several challenges that paramedics face related to poor organisational preparation for transfer of the critically ill neonate, and other crucial issues that compromise the transfer such as inadequate or defective equipment. Conclusion There is a need for greater scrutiny of the transfer process and a commitment from stakeholders to begin addressing the challenges confronting the safe transfer of critically ill neonates.

“…A lack of practitioner development and training had been identified by the World Health Organization as the main threat to patient safety (5). Furthermore, a recent South African study found that 'time delays, equipment problems, adverse events and a lack of skills' may be some of the factors contributing to the increasing neonatal mortality (6). This study aimed to evaluate the experience of and preparedness of ALS providers in the Western Cape province to undertake intensive care of critically ill neonates during interfacility transfers.…”

Section: Introductionmentioning

confidence: 99%

Preparedness of Western Cape Advanced Life Support Providers to Provide Clinical Stabilisation and Intensive Care for Neonatal Interfacility Transfers

Ismail

Prakaschandra

2020

Introduction The Western Cape is a province in South Africa – known for the port city of Cape Town – surrounded by the Indian and Atlantic oceans. The transport of high-risk neonates between neonatal intensive care units in the Western Cape of South Africa is performed by advanced life support (ALS) providers.The implications of this practice have not been documented. This study will evaluate the preparedness of ALS providers to undertake intensive care of critically ill neonates during interfacility transfers.MethodsData collection was performed using a questionnaire with a response rate of 81% (n=145). The data analysis encompassed descriptive statistics using tables and figures. Inferential statistics was done using the chi-square test with a significance reported for p<0.05. Reliability was determined using Cronbach’s alpha.ResultsThe respondents highlighted that their initial ALS training was not adequate to prepare them for managing critically ill neonates. This view was expressed by the greater majority (n=63, 43.4%) when asked about their combined neonatal theory and practical training notional hours of their curriculum which focussed on managing critically ill neonates. ConclusionThere is an urgent need to improve the training programs of ALS providers with regards to neonatology. Numerous factors affecting the preparedness of ALS providers to manage critically ill neonates have been highlighted.