DOI: 10.21045/2071-5021-2016-50-4-7

Nizamova E.R.
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Contacts: Elvira R. Nizamova, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract

Significance. Medical transportation is an important step in care delivery to neonates and preterm babies and directly affects survival of children at successive levels of care delivery. The purpose of the work is to assess compliance of practices to transport neonates from the first to the second level health care facility with the current standards.

Materials and Methods. The article presents data on 519 transportations of neonates and preterm babies to the second level care facility in Moscow in April 2015. The article also outlines structure of the children’s morbidity, quality assessment of medical records used by the mobile resuscitation team, describes major drawbacks in care organization during transportation.

Results. The study identified the following problems: lack of the uniform medical documentation of mobile resuscitation teams, lack of the standard approach to score severity of the patient's condition that prevents quality assessment of the transportation service, timely referral due to underestimation of the threatening conditions. The study also detected cases of simultaneous transportation of several children, incomplete membership of mobile teams, lack of infusion therapy, non-use of infant incubators, cases of leaving the patient at the first level facility because “agreement of transfer” was not made, which increases the risk of complications in patients, and violates the principle of care continuity.

Conclusions. Use of standard medical documentation and organization of the internal quality management of care during transportation of neonates and preterm babies reduces the risk of complications during transportation, and ensures continuity of care between all levels of care delivery.

Evacuation of preterm and severe ill neonates in incubators with monitoring of vital functions and maintaining homeostasis improves survival rates.

Dispatcher center handles the following issues: meeting deadlines for transfer, rational routing of patient with due regard to severity of the condition, diagnosis, availability of beds at the second level facility of care delivery, provision of information to manage quality of care during transportation.
Results can be used to improve transportation of neonates and preterm babies in the Russian Federation.

Êëþ÷åâûå ñëîâà. Òðàíñïîðòèðîâêà íîâîðîæäåííûõ è íåäîíîøåííûõ äåòåé; âòîðîé ýòàï âûõàæèâàíèÿ; ñêîðàÿ ìåäèöèíñêàÿ ïîìîùü; ýêñòðåííàÿ ïîìîùü â íåîíàòîëîãèè.

Keywords. Transportation of newborn and premature babies; second level of care delivery; ambulance; emergency care in neonatology.

References

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