Dr Jackie Gardiner1, Ms Kylie Mcdonald1, Ms Joanne Blacker1, Dr Sam Athikarisamy2,4, Dr Mary Sharp3,4, Dr Jonathan Davis1,4
1nets Wa, Perth Children’s Hospital , Nedlands, Australia, 2neonatal Directorate, Perth Children’s Hospital , Nedlands, Australia, 3neonatal Directorate, King Edward Memorial Hospital, Subiaco, Australia, 4university Of Western Australia, Perth, Australia
Abstract:
Aims: To compare unintended events in transfers performed by neonatal specialist (NS) and non-neonatal specialist (NNS) teams in Western Australia (WA).
Methods: Retrospective comparison of neonatal transfers from the Kimberley and Pilbara regions (WA) to tertiary services, King Edward Memorial (perinatal) and Perth Children’s Hospital NICU, in Perth (state capital, distance up to 2200km) between January 2018 – June 2021. NS teams travelled from the tertiary to the referring centre and back. NNS travelled from the referring to the tertiary centre. Transport time, team composition, total unintended clinical, endotracheal tube (ETT), and logistic events were compared. Categorial data are expressed as numbers (%) and compared by chi-squared test; continuous data are expressed as median (interquartile range) and compared by Mann-Whitney U test.
Results: During the study period, 3,709 infants were transported in WA to tertiary services for escalation of care: 119/3709 (3.2%) from the Kimberley and Pilbara, 49 with NS and 70 with NNS teams. NNS had shorter transport times than NS teams (508(433 – 610) vs 675(610 – 735) min; p<0.0001). Neonatal nurses were on NS more than NNS teams (36/49(73.5%) vs 6/70(8.6%); RR 5.08 95% CI (3.13 to 8.56), p<0.001). Total unintended clinical and ETT events were less in NS vs. NSS teams (28/49(57%) vs. 54/70(77%); RR 0.66 95%CI (0.40 to 0.92), p=0.03) and (0/26(0%) vs. 7/23(30%); p=0.004).
Conclusion: Although NS teams had longer transport times there were fewer unintended clinical and ETT events. NS teams should be considered as the first choice to undertake neonatal transport.
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