Health Services Unit, KEMRI-Wellcome Trust Research Programme, 197 Lenana Place, Lenana Road, P. O. Box 43640, Nairobi, 00100, Kenya.
Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
BMC Pediatr. 2022 Feb 18;22(1):99. doi: 10.1186/s12887-021-02965-w.
Audit of facility-based care provided to small and sick newborns is a quality improvement initiative that helps to identify the modifiable gaps in newborn care (BMC Pregnancy Childbirth 14: 280, 2014). The aim of this work was to identify literature on modifiable factors in the care of newborns in the newborn units in health facilities in low-middle-income countries (LMICs). We also set out to design a measure of the quality of the perinatal and newborn audit process.
The scoping review was conducted using the methodology outlined by Arksey and O'Malley and refined by Levac et al, (Implement Sci 5:1-9, 2010). We reported our results using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. We identified seven factors to ensure a successful audit process based on World Health Organisation (WHO) recommendations which we subsequently used to develop a quality of audit process score.
We conducted a structured search using PubMed, CINAHL, EMBASE, LILACS, POPLINE and African Index Medicus.
Studies published in English between 1965 and December 2019 focusing on the identification of modifiable factors through clinical or mortality audits in newborn care in health facilities from LMICs.
We extracted data on the study characteristics, modifiable factors and quality of audit process indicators.
A total of six articles met the inclusion criteria. Of these, four were mortality audit studies and two were clinical audit studies that we used to assess the quality of the audit process. None of the studies were well conducted, two were moderately well conducted, and four were poorly conducted. The modifiable factors were divided into three time periods along the continuum of newborn care. The period of newborn unit care had the highest number of modifiable factors, and in each period, the health worker related modifiable factors were the most dominant.
Based on the significant number of modifiable factors in the newborn unit, a neonatal audit tool is essential to act as a structured guide for auditing newborn unit care in LMICs. The quality of audit process guide is a useful method of ensuring high quality audits in health facilities.
对医疗机构提供的小型和患病新生儿护理进行审核是一项质量改进举措，有助于发现新生儿护理中的可改进差距（BMC Pregnancy Childbirth 14: 280, 2014）。这项工作的目的是确定中低收入国家（LMICs）医疗机构新生儿病房中新生儿护理的可改变因素的文献。我们还着手设计一种衡量围产期和新生儿审核流程质量的方法。
使用 Arksey 和 O'Malley 概述的方法并由 Levac 等人进行了细化（Implement Sci 5:1-9, 2010）进行了范围综述。我们使用世界卫生组织（WHO）建议确定了七个确保审核过程成功的因素，我们随后使用这些因素开发了审核过程质量评分。
我们使用 PubMed、CINAHL、EMBASE、LILACS、POPLINE 和 African Index Medicus 进行了结构化搜索。
在 1965 年至 2019 年 12 月期间，以英语发表的研究重点是通过在来自 LMICs 的医疗机构中进行临床或死亡率审核来确定可改变的因素。
我们提取了有关研究特征、可改变因素和审核过程质量指标的数据。
共有 6 篇文章符合纳入标准。其中，4 篇是死亡率审核研究，2 篇是临床审核研究，我们使用这些研究来评估审核过程的质量。没有一篇研究是精心进行的，两篇是适度精心进行的，四篇是精心进行的。可改变的因素分为新生儿护理连续体的三个时间段。新生儿病房护理期间的可改变因素数量最多，在每个时期，与卫生工作者相关的可改变因素是最主要的。
基于新生儿病房中大量的可改变因素，新生儿审核工具对于在 LMICs 中对新生儿病房护理进行审核是必要的。审核过程质量指南是确保医疗机构高质量审核的有用方法。
