An analysis of inter-healthcare facility transfer of neonates within the eThekwini Health District of KwaZulu-Natal, South Africa

Objectives. To investigate delays in the transfer of neonates between healthcare facilities and to detect any adverse events encountered during neonatal transfer.Methods. A prospective study was conducted from December 2011 to January 2012. A quantitative, non-experimental design was used to undertake a descriptive analysis of 120 inter-healthcare facility transfers of neonates within the eThekwini Health District (Durban) of KwaZulu-Natal Province, South Africa. Data collection was via questionnaire. Data collection was restricted to the Emergency Medical Services (EMSs) of eThekwini Health District, which is the local public ambulance provider.Results. All transfers were undertaken by road ambulances: 83 (62.2%) by frontline ambulances; 35 (29.2%) by the obstetric unit; and 2 (1.7%) by the planned patient transport vehicles. Twenty-nine (24.2%) transfers involved critically ill neonates. The mean (standard deviation (SD)) time to complete an inter-healthcare facility transfer was 3 h 49 min (1 h 57 min) (range 0 h 55 min - 10 h 34 min). Problems with transfer equipment were common due to poor resource allocation, malfunctioning equipment, inappropriate equipment for the type of transfer and dirty or unsterile equipment. The study identified 10 (8.3%) physiologically related adverse events, which included 1 (0.8%) death plus a further 18 (15.0%) equipment-related adverse events.Conclusions. EMS is involved in transporting a significant number of intensive care and non-intensive care neonates between healthcare facilities. This study has identified numerous factors affecting the efficiency of inter-facility transfer of neonates and highlights a number of areas requiring improvement

An analysis of inter-healthcare facility transfer of neonates within the eThekwini health district of KwaZulu-Natal

To assess the time frames for the inter-healthcare facility transfer of neonates and investigate the factors that may have led to delays in the transfer; and investigate any adverse events encountered during the transfer of the neonate. Methods: A prospective study was conducted from December 2011 to January 2012. A quantitative, non-experimental design was used to undertake a descriptive analysis of 120 inter-healthcare facility transfers of neonates within the eThekwini Health District of KwaZulu-Natal. Data collection relied upon two questionnaires. Results: All the transfers were undertaken by road ambulances of which 83 (62.2%) by the operational ambulance units, 35 (29.2%) by the obstetric unit and 2 (1.7%) by the planned patient transport units. Twenty nine (24.2%) were specialised transfers. The mean time ± standard deviation (SD) to complete an inter-healthcare facility transfer was 3 h 49 min ± 1 h 57 min with the minimum time of 5 min and the maximum time of 10 h 34 min. Equipment required for neonatal transport was a major problem due to poor resource allocation, and malfunctioning, inappropriate, insufficient and unsterile equipment. The study identified 10 (8.3%) physiological related adverse events which included 1 (0.8%) death and 18 (15.0%) equipment related adverse events. Conclusions: The EMRS eThekwini Health District is involved in the transportation of a significant number of intensive care and non-intensive care neonates between healthcare facilities. This study has identified numerous factors affecting the efficiency of inter-facility transfer of neonates highlighting various areas requiring improvement