Jodeiry Behzad, Heidarzadeh Mohammad, Mirnia Kayvan, Akrami Forouzan, Heidarabadi Seifoallah, Ebadi Ali
Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Prev Med. 2015 Apr 29;6:35. doi: 10.4103/2008-7802.156072. eCollection 2015.
Early childhood development is one of the most social determinants of health that must be notified in order to reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow-up surveillance system to identify high-risk infants (HRI) and their health problems for timely intervention after discharge. This study was carried out to design and pilot high-risk infant follow-ups (HRIFs) surveillance system, in Alzahra Hospital, a tertiary level center of Tabriz University of Medical Sciences (TUOMS), in 2012-2013.
In this qualitative research after studying international documents, consensus about criteria of HRIs accomplished by focus group discussion. Then, Delphi agreement technique was used to finalizing assessment timetable. In the second phase, we piloted the designed surveillance system in Alzahra Hospital, a tertiary level center of TUOMS. Pilot study was implemented by follow-up team organized in designed model at the first phase of the study. Then, the findings of the pilot study were being assessed by an expert panel. If the members agreed on made decisions, they were being placed on the agenda of the national committee of development care of newborns for final approval.
High-risk infants follow-up surveillance system was designed in following steps: Defining of evidence-based criteria of HRIs, organizing the follow-up team, regulating the organs and neurodevelopment assessment timetable, publishing a health certificate notebook for HRIs, and designing Access database software for data collection, report and evaluation.
We designed and piloted HRIFs surveillance system, so this system was institutionalized in Alzahra Hospital, finally. It can be prepared to apply in the whole country, after detecting the quantitative outcomes and developing the program in East Azarbijan.
儿童早期发展是健康的最重要社会决定因素之一，必须加以关注以减少社会差距和不平等。尽管新生儿重症监护病房日益发展，新生儿死亡率不断下降，但仍没有后续监测系统来识别高危婴儿（HRI）及其健康问题，以便在出院后及时进行干预。本研究于2012 - 2013年在大不里士医科大学（TUOMS）的三级中心阿尔扎赫拉医院开展，旨在设计并试行高危婴儿随访（HRIFs）监测系统。
在这项定性研究中，在研究国际文件后，通过焦点小组讨论就高危婴儿的标准达成共识。然后，采用德尔菲共识技术确定评估时间表。在第二阶段，我们在TUOMS的三级中心阿尔扎赫拉医院试行设计好的监测系统。试点研究由在研究第一阶段按设计模式组建的随访团队实施。然后，由一个专家小组评估试点研究的结果。如果成员们对所作决定达成一致，这些决定将被列入国家新生儿发育护理委员会的议程以供最终批准。
高危婴儿随访监测系统按以下步骤设计：确定基于证据的高危婴儿标准、组建随访团队、规范器官和神经发育评估时间表、为高危婴儿发布健康证明手册，以及设计用于数据收集、报告和评估的Access数据库软件。
我们设计并试行高危婴儿随访监测系统，最终该系统在阿尔扎赫拉医院实现了制度化。在检测到定量结果并在东阿塞拜疆制定该计划后，它可以准备在全国应用。
