Establishing a neonatal database in a tertiary hospital in Rwanda – an observational study

Choi, Jaeseok; Urubuto, Fedine; Dusabimana, Raban; Agaba, Faustine; Teteli, Raissa; Kumwami, Muzungu; O’Callahan, Cliff; Cartledge, Peter

doi:10.1080/20469047.2019.1607056

Cited by 10 publications

(17 citation statements)

References 20 publications

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“…29,30 Also, NRFs allow for tracking data to assist with clinical benchmarking for transport outcomes, a much-needed measure in neonatal inter-hospital transfer and neonatal registries. [31][32][33] By utilising a modified Delphi consensus process, we have incorporated core items that previous NRFs included while tailoring the form for use specifically in a resource-limited setting. The participants contributing to the consensus process had a broad length of experience and diverse backgrounds and training.…”

Section: Discussionmentioning

confidence: 99%

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Closing the communication gap in neonatal inter-hospital transfer: a neonatal referral form for resource-limited settings - a modified e-Delphi-consensus study

et al. 2021

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Background: Standardised neonatal referral forms (NRFs) facilitate effective communication between healthcare providers and ensure continuity of care between facilities, which are essential for patient safety. We sought to determine the essential data items, or core clinical information (CCI), that should be conveyed for neonatal inter-hospital transfer in resource-limited settings (Rounds 1 to 3) and to create an NRF suitable for our setting (Round 4). Methods: We conducted an international, four-round, modified Delphi-consensus study. Round-1 was a literature and internet search to identify existing NRFs. In Round-2 and -3, participants were Rwandan clinicians and international paediatric healthcare practitioners who had worked in Rwanda in the five years before the study. These participants evaluated the draft items and proposed additional items to be included in an NRF. Round-4 focused on creating the NRF and used five focus groups of Rwandan general practitioners at district hospitals. Results: We identified 16 pre-existing NRFs containing 125 individual items. Of these, 91 items met the pre-defined consensus criteria for inclusion in Round-2. Only 33 items were present in more than 50% of the 16 NRFs, confirming the need for this consensus study. In Round-2, participants proposed 12 new items, six of which met the pre-defined consensus criteria. In Round-3, participants scored items for importance, and 57 items met the final consensus criteria. In Round-4, 29 general practitioners took part in five focus groups; a total of 16 modifications were utilised to finalise the NRF. Conclusions: We generated a novel, robust, NRF that may be readily employed in resource-limited settings to communicate the essential clinical information to accompany a neonate requiring inter-hospital transfer.

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Section: Discussionmentioning

confidence: 99%

“…These data can form the foundation for future quality improvement initiatives in neonatal inter-hospital transfers or centres establishing neonatal registries. 33…”

Section: Clinical Applicationmentioning

confidence: 99%

Closing the communication gap in neonatal inter-hospital transfer: a neonatal referral form for resource-limited settings - a modified e-Delphi-consensus study

et al. 2021

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“…Once implemented quantitative investigation of changes in care would be required as evidence in this setting is lacking. This may involve regular data collection through a Neonatal Registry [22] to allow for measures of change and loops of Quality Improvement [36]. Qualitative research would also be important to identify how individual populations want to receive education and which aspects they find most beneficial for caring for their admitted newborn.…”

Section: Discussionmentioning

confidence: 99%

“…CHUK is a tertiary level hospital with the newborn unit has approximately 560 admissions and caters for 20–30 infants every day, with three Kangaroo Mother Care (KMC) spaces. The obstetric department is a referral unit and the principal site for approximately 2000 high-risk deliveries per year [22]. MDH is a district hospital, located in Kigali city, and serves approximately 1 million people.…”

Section: Methodsmentioning

confidence: 99%

“…Both neonatal units would be considered a level II by USA standards [23] and level I by UK standards [24], providing simple therapies such as CPAP and intravenous fluids, without mechanical ventilation or total parental nutrition. There are no admission weight cut-offs, and standard practice requires a weight of 1.8 kg before discharge [22]. Group 2 - Expert stakeholders: We defined an “expert” as professionals who had experience in clinical care for neonates and their families in a resource-limited setting, such as Rwanda.…”

Section: Methodsmentioning

confidence: 99%

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What topics should we teach the parents of admitted neonates in the newborn care unit in the resource-limited setting - a Delphi study

Musabyemungu

Willson

Batenhorst

et al. 2019

matern health, neonatol and perinatol

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Background In resource-limited settings, such as Rwanda, health care profession (HCP) to neonate ratios are low, and therefore caregivers play a significant role in providing care for their admitted neonates. To provide such Family Integrated Care, caregivers need knowledge, skills, and confidence. The objective of this study was to identify consensus from key stakeholders regarding the priority topics for a “parental neonatal curriculum.” Methods A three-round Delphi-study was conducted. During Round-1, face-to-face interviews were undertaken and responses coded and categorized into themes. In Round-2, participants were presented with Round-1 feedback and asked to provide additional topics in respective themes. In Round-3, respondents were asked to rank the importance of these items using a 9-point Likert scale. Results Ten, 36 and 40 stakeholders participated in Rounds-1, − 2 and − 3 respectively, including parents, midwives, nurses and physicians. Twenty and 37 education topics were identified in Rounds-1 and -2 respectively. In Round-3 47 of the 57 presented outcomes met pre-defined criteria for inclusion in the “parental neonatal curriculum.” Conclusion We describe a “parental neonatal curriculum,” formed using robust consensus methods, describing the core topics required to educate parents of neonates admitted to a newborn care unit. The curriculum has been developed in Rwanda and is relevant to other resource-limited settings. Electronic supplementary material The online version of this article (10.1186/s40748-019-0106-8) contains supplementary material, which is available to authorized users.

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Creating a Medication Therapy Observational Research Database from an Electronic Medical Record: Challenges and Data Curation

Rödle,

Prokosch,

Neumann

et al. 2024

Appl Clin Inform

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Background Observational research has shown its potential to complement experimental research and clinical trials by secondary use of treatment data from hospital care processes. It can also be applied to better understand pediatric drug utilization for establishing safer drug therapy. Clinical documentation processes often limit data quality in pediatric medical records requiring data curation steps, which are mostly underestimated. Objectives The objectives of this study were to transform and curate data from a departmental electronic medical record into an observational research database. We particularly aim at identifying data quality problems, illustrating reasons for such problems and describing the systematic data curation process established to create high-quality data for observational research. Methods Data were extracted from an electronic medical record used by four wards of a German university children's hospital from April 2012 to June 2020. A four-step data preparation, mapping, and curation process was established. Data quality of the generated dataset was firstly assessed following an established 3 × 3 Data Quality Assessment guideline and secondly by comparing a sample subset of the database with an existing gold standard. Results The generated dataset consists of 770,158 medication dispensations associated with 89,955 different drug exposures from 21,285 clinical encounters. A total of 6,840 different narrative drug therapy descriptions were mapped to 1,139 standard terms for drug exposures. Regarding the quality criterion correctness, the database was consistent and had overall a high agreement with our gold standard. Conclusion Despite large amounts of freetext descriptions and contextual knowledge implicitly included in the electronic medical record, we were able to identify relevant data quality issues and to establish a semi-automated data curation process leading to a high-quality observational research database. Because of inconsistent dosage information in the original documentation this database is limited to a drug utilization database without detailed dosage information.

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Establishing a neonatal database in a tertiary hospital in Rwanda – an observational study

Cited by 10 publications

References 20 publications

Closing the communication gap in neonatal inter-hospital transfer: a neonatal referral form for resource-limited settings - a modified e-Delphi-consensus study

Closing the communication gap in neonatal inter-hospital transfer: a neonatal referral form for resource-limited settings - a modified e-Delphi-consensus study

What topics should we teach the parents of admitted neonates in the newborn care unit in the resource-limited setting - a Delphi study

Creating a Medication Therapy Observational Research Database from an Electronic Medical Record: Challenges and Data Curation

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