PDF(Pubmed)
Abstract：
Background: Standardised neonatal referral forms (NRFs) facilitate effective communication between healthcare providers and ensure continuity of care between facilities, which are essential for patient safety. We sought to determine the essential data items, or core clinical information (CCI), that should be conveyed for neonatal inter-hospital transfer in resource-limited settings (Rounds 1 to 3) and to create an NRF suitable for our setting (Round 4). Methods: We conducted an international, four-round, modified Delphi-consensus study. Round-1 was a literature and internet search to identify existing NRFs. In Round-2 and -3, participants were Rwandan clinicians and international paediatric healthcare practitioners who had worked in Rwanda in the five years before the study. These participants evaluated the draft items and proposed additional items to be included in an NRF. Round-4 focused on creating the NRF and used five focus groups of Rwandan general practitioners at district hospitals. Results: We identified 16 pre-existing NRFs containing 125 individual items. Of these, 91 items met the pre-defined consensus criteria for inclusion in Round-2. Only 33 items were present in more than 50% of the 16 NRFs, confirming the need for this consensus study. In Round-2, participants proposed 12 new items, six of which met the pre-defined consensus criteria. In Round-3, participants scored items for importance, and 57 items met the final consensus criteria. In Round-4, 29 general practitioners took part in five focus groups; a total of 16 modifications were utilised to finalise the NRF. Conclusions: We generated a novel, robust, NRF that may be readily employed in resource-limited settings to communicate the essential clinical information to accompany a neonate requiring inter-hospital transfer.
摘要：
背景：标准化的新生儿转诊表（NRF）促进医疗保健提供者之间的有效沟通，并确保设施之间的护理连续性，这对患者安全至关重要。我们试图确定基本数据项，或核心临床信息(CCI)，应在资源有限的环境中（第1至第3轮）进行新生儿医院间转院，并创建适合我们的环境的NRF（第4轮）。方法：我们进行了一项国际研究，四轮，改良的德尔菲共识研究。Round-1是用于识别现有NRF的文献和互联网搜索。在第2轮和第3轮中，参与者是卢旺达临床医生和国际儿科医师，他们在研究前五年在卢旺达工作。这些与会者评估了项目草案，并提出了将列入国家成果框架的其他项目。第四轮侧重于创建NRF，并在地区医院使用了五个卢旺达全科医生焦点小组。结果：我们确定了16个预先存在的NRF，包含125个单独的项目。其中,91个项目符合列入第二轮的预定共识标准。在16个NRF的50%以上中，只有33个项目存在，证实了这项共识研究的必要性。在第二轮中，与会者提出了12个新项目，其中六个符合预定义的共识标准。在第三轮中，参与者对项目的重要性进行了评分，57个项目符合最终共识标准。在第四轮中，29名全科医生参加了五个焦点小组；总共使用了16项修改来完成NRF。结论：我们创作了一部小说，健壮,NRF可以很容易地在资源有限的环境中使用，以传达必要的临床信息，以伴随需要医院间转移的新生儿。
