Jacqueline Gardiner, Kylie McDonald, Joanne Blacker, Sam Athikarisamy, Mary Sharp, Jonathan Davis
{"title":"西澳大利亚州长距离新生儿医院间运输中的意外事件：新生儿专科和非新生儿专科运输团队的比较","authors":"Jacqueline Gardiner, Kylie McDonald, Joanne Blacker, Sam Athikarisamy, Mary Sharp, Jonathan Davis","doi":"10.1016/j.jpedcp.2024.200102","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare unintended events in transfers performed by neonatal specialist (NS) and non-neonatal specialist (NNS) teams in Western Australia (WA).</p><p><strong>Study design: </strong>Retrospective comparison of neonatal transfers from the Kimberley and Pilbara regions (WA) to tertiary services, King Edward Memorial (perinatal) and Perth Children's Hospital Neonatal Intensive Care Unit, in Perth (state capital, distance up to 2200 km) between January 2018 and June 2021. NS teams traveled from the tertiary to the referring center and back. NNS traveled from the referring to the tertiary center. Transport time, team composition, total unintended clinical and endotracheal tube (ETT) events were compared. Categorial data are expressed as numbers (%) and compared by χ<sup>2</sup> test; continuous data are expressed as median (IQR) and compared by Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>During the study period, 3709 infants were transported in WA to tertiary services for escalation of care: 119 of 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] minutes; <i>P</i> < .0001). Neonatal nurses were on NS more than NNS teams (36/49 [73.5%] vs 6/70 [8.6%]; RR 5.08, 95% CI 3.13-8.56, <i>P</i> < .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 0.40-0.92, <i>P</i> = .03) and (0/26 [0%] vs 7/23 [30%]; <i>P</i> = .004).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"11 ","pages":"200102"},"PeriodicalIF":0.0000,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824664/pdf/","citationCount":"0","resultStr":"{\"title\":\"Unintended Events in Long-Distance Neonatal Interhospital Transport in Western Australia: A Comparison of Neonatal Specialist and Non-Neonatal Specialist Transport Teams.\",\"authors\":\"Jacqueline Gardiner, Kylie McDonald, Joanne Blacker, Sam Athikarisamy, Mary Sharp, Jonathan Davis\",\"doi\":\"10.1016/j.jpedcp.2024.200102\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare unintended events in transfers performed by neonatal specialist (NS) and non-neonatal specialist (NNS) teams in Western Australia (WA).</p><p><strong>Study design: </strong>Retrospective comparison of neonatal transfers from the Kimberley and Pilbara regions (WA) to tertiary services, King Edward Memorial (perinatal) and Perth Children's Hospital Neonatal Intensive Care Unit, in Perth (state capital, distance up to 2200 km) between January 2018 and June 2021. NS teams traveled from the tertiary to the referring center and back. NNS traveled from the referring to the tertiary center. Transport time, team composition, total unintended clinical and endotracheal tube (ETT) events were compared. Categorial data are expressed as numbers (%) and compared by χ<sup>2</sup> test; continuous data are expressed as median (IQR) and compared by Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>During the study period, 3709 infants were transported in WA to tertiary services for escalation of care: 119 of 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] minutes; <i>P</i> < .0001). Neonatal nurses were on NS more than NNS teams (36/49 [73.5%] vs 6/70 [8.6%]; RR 5.08, 95% CI 3.13-8.56, <i>P</i> < .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 0.40-0.92, <i>P</i> = .03) and (0/26 [0%] vs 7/23 [30%]; <i>P</i> = .004).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":519930,\"journal\":{\"name\":\"Journal of pediatrics. Clinical practice\",\"volume\":\"11 \",\"pages\":\"200102\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824664/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of pediatrics. Clinical practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jpedcp.2024.200102\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pediatrics. Clinical practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jpedcp.2024.200102","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Unintended Events in Long-Distance Neonatal Interhospital Transport in Western Australia: A Comparison of Neonatal Specialist and Non-Neonatal Specialist Transport Teams.
Objective: To compare unintended events in transfers performed by neonatal specialist (NS) and non-neonatal specialist (NNS) teams in Western Australia (WA).
Study design: Retrospective comparison of neonatal transfers from the Kimberley and Pilbara regions (WA) to tertiary services, King Edward Memorial (perinatal) and Perth Children's Hospital Neonatal Intensive Care Unit, in Perth (state capital, distance up to 2200 km) between January 2018 and June 2021. NS teams traveled from the tertiary to the referring center and back. NNS traveled from the referring to the tertiary center. Transport time, team composition, total unintended clinical and endotracheal tube (ETT) events were compared. Categorial data are expressed as numbers (%) and compared by χ2 test; continuous data are expressed as median (IQR) and compared by Mann-Whitney U test.
Results: During the study period, 3709 infants were transported in WA to tertiary services for escalation of care: 119 of 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] minutes; P < .0001). Neonatal nurses were on NS more than NNS teams (36/49 [73.5%] vs 6/70 [8.6%]; RR 5.08, 95% CI 3.13-8.56, P < .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 0.40-0.92, P = .03) and (0/26 [0%] vs 7/23 [30%]; P = .004).
Conclusions: 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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