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在新生儿院际转运中弥合沟通差距:资源有限环境下的新生儿转诊表——改良版电子德尔菲共识研究。

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

机构信息

Department of Pediatrics and Child Health, University of Rwanda, Kigali, Rwanda.

Department of Pediatrics, University Teaching Hospital of Kigali, Kigali, Rwanda.

出版信息

F1000Res. 2021 May 10;10:365. doi: 10.12688/f1000research.50980.2. eCollection 2021.

Abstract

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). 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. 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. 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.

摘要

标准化新生儿转诊表(NRF)有助于医疗保健提供者之间进行有效的沟通,并确保设施之间的护理连续性,这对患者安全至关重要。我们旨在确定在资源有限的环境中(第 1 至 3 轮)进行新生儿医院间转院时应传达的基本数据项或核心临床信息(CCI),并创建适合我们环境的 NRF(第 4 轮)。我们进行了一项国际性的四轮改良 Delphi 共识研究。第 1 轮是对现有 NRF 的文献和互联网搜索。在第 2 轮和第 3 轮中,参与者是卢旺达临床医生和国际儿科医疗保健从业者,他们在研究前五年内在卢旺达工作过。这些参与者评估了草案项目,并提出了要纳入 NRF 的其他项目。第 4 轮专注于创建 NRF,并使用卢旺达地区医院的五组普通医生进行了焦点小组讨论。我们确定了 16 份包含 125 个单独项目的现有 NRF。其中,91 个项目符合纳入第 2 轮的预先定义的共识标准。只有 33 个项目出现在 16 个 NRF 中的 50%以上,这证实了进行这项共识研究的必要性。在第 2 轮中,参与者提出了 12 个新项目,其中 6 个符合预先定义的共识标准。在第 3 轮中,参与者对项目的重要性进行了评分,有 57 个项目符合最终共识标准。在第 4 轮中,29 名普通医生参加了五组焦点小组;共进行了 16 项修改,以最终确定 NRF。我们生成了一种新颖、强大的 NRF,可在资源有限的环境中轻松用于传达需要医院间转院的新生儿的基本临床信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e32c/9201495/9301f4d1fde4/f1000research-10-125455-g0000.jpg

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