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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:
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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.
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