Kangaroo position during neonatal ground ambulance transport: Parents' experiences

Prehospital emergency care family satisfaction scale for care provided by emergency medical technicians: Scale development and validation

RATIONALE

To date, family satisfaction with emergency medical technicians (EMTs) has only been reported through narrative statements in subjective evaluations. Although a quantitative assessment of healthcare professional satisfaction is desirable, no specific measures have been devised to assess family satisfaction with the healthcare and care provided by EMTs.

AIMS AND OBJECTIVES

This study aimed to develop and validate an EMT care family satisfaction scale to measure patient satisfaction with prehospital emergency care.

METHODS

The study population comprised 216 family members (N = 216) of patients who used ambulances between November 2020 and May 2021 in a single region in Japan. Questionnaires were distributed to the participants who provided informed consent. An exploratory factor analysis of construct validity was performed to validate the Family Satisfaction Scale. The Cronbach's alpha was used to validate the internal consistency reliability of the scale.

RESULTS

The exploratory factor analysis results revealed a four-factor structure: 'explanation and communication,' 'physical treatment,' 'psychological support,' and 'environment in the ambulance.' The Cronbach's range (0.80-0.93) for the total score for each of these four factors and the overall total score confirmed favorable internal reliability of this study.

CONCLUSIONS

The family satisfaction scale developed in this study was constructed and validated to highlight the role of EMTs and needs of the families in the prehospital care settings. Moreover, this scale can be applied in the evaluation and consideration of interventions to improve family satisfaction with EMTs.

Skin-to-skin transfer from the delivery room to the neonatal unit for neonates of 1,500g or above: a feasibility and safety study

Objective

Immediate skin-to-skin contact (SSC) is already standard care for healthy term newborns, but its use for term or preterm newborns requiring admission to neonatal intensive care unit (NICU) with or without respiratory support is challenging. This study aimed to assess the safety and feasibility of SSC during the transfer of newborn infants, using a new purpose-built mobile shuttle care-station, called "Tandem".

Material and methods

A monocentric prospective observational study was conducted at the tertiary referral center of the Université libre de Bruxelles in Brussels, Belgium after ethical approval by Hopital Erasme's Ethics Committee (ClinicalTrials.gov ID: NCT06198478). Infants born with a birth weight above 1,500 g were included. Following initial stabilization, infants were placed in SSC with one of their parents and transferred to the NICU using the Tandem.

Results

Out of 65 infants initially included, 64 (98.5%) were successfully transported via SSC using the Tandem. One transfer was not successful due to last minute parental consent withdrawal. The median (range) duration of continuous skin-to-skin contact after birth was 120 min (10-360). SSC transfers were associated with gradually decreasing heart rate (HR) values, stable oxygen saturation levels (SpO2), and no increase in median fraction of inspired oxygen (FiO2). Heatloss was predominantly observed during initial setup of SSC. There was no significant difference in the occurrence of tachycardia, desaturation or hypothermia between preterm and term neonates. No equipment failures compromising the transfer were recorded.

Conclusion

Skin-to-skin transfer of infants with a birthweight of equal or above 1,500 g using the Tandem shuttle is feasible and associated with stable physiological parameters. This method facilitates early bonding and satisfies parents.

Clinical Trial Registration

ClinicalTrials.gov (NCT06198478).

Measuring experience of and satisfaction with newborn care: a scoping review of tools and measures

BACKGROUND

Standardised measures on experience of care are essential to understanding the care women and newborns receive and to designing appropriate interventions and responses. This review builds on ongoing work in the realm of maternity care and complements it by reviewing existing tools and measures to assess experience of and satisfaction with the care of the newborn.

METHODS

We conducted a scoping review of published literature to identify measures and tools of experience (physiological or indirect) and satisfaction with newborn care. We systematically searched five bibliographic databases from 1 January 2010 through 1 December 2022 and contacted professional networks. Using a predefined evidence template, we extracted data on the studies and the tools' characteristics. We mapped the tools and measures against the WHO quality of care frameworks to identify the most frequent measured domains of care and to highlight existing gaps.

RESULT

We identified 18 292 records of which 72 were eligible. An innovative finding of this review is the inclusion of newborn perspectives through behavioural responses, physiological signals, pain profiles as well as other non-verbal cues as markers of newborn experience. Domains related to parental participation and decision-making, ensuring continuity of care and receiving coordinated care, were the most measured across the included tools.

CONCLUSION

Comprehensive and validated instruments measuring all aspects of care are needed. Developing a robust theoretical ground will be fundamental to the design and utilisation of standardised tools and measures.

PROTOCOL REGISTRATION DETAILS

This review was registered and published on protocol.io (dx.doi.org/10.17504/protocols.io.bvk7n4zn).

Effect of Kangaroo Mother Care Transport in Preventing Moderate Hypothermia in Low Birth Weight Babies During Transportion to Home After Discharge: A Randomized Controlled Trial

BACKGROUND

Transport of neonates is often neglected, which results in high mortality of neonates during transport.

OBJECTIVES

To determine the effectiveness of kangaroo mother care (KMC) in terms of hypothermia prevention during transport from hospital to home for low birth weight neonates.

STUDY DESIGN

Randomized controlled trial.

PARTICIPANTS

A total of 152 low birth weight neonates being discharged from the neonatal intensive care unit of our hospital between March, 2021 and August, 2022.

INTERVENTION

Neonates in the study group (n=76) received KMC during transport from the hospital to home, while the control group (n=76) did not receive KMC during transport. Axillary temperature was recorded in both groups at the time of discharge, every 5 minutes during transport, and on reaching home.

OUTCOMES

Hypothermia episodes in neonates while receiving KMC compared to neonates not receiving KMC.

RESULTS

Primary endpoint of the study was moderate hypothermia. During transport, 23 (30.3%) neonates in the control group experienced moderate hypothermia during transport, which was statistically significant [0% vs 30.3%; P<0.001]. From 10 minutes of transport till the neonates reached home, the mean (SD) temperature in the study group was significantly higher than in the control group [ 36.8 (0.23) °C vs 36.6 (0.3) °C; P<0.001] at time 15 minutes. Similar results were noted in preterm neonates [36.7 (0.25) °C vs 36.5 (0.29) °C; P<0.001] at time 15 minutes. The number of hypothermia episodes was more in the control group than in the study group during most of the transport time [7.6% vs 43.2%; P<0.001] at time 15 minutes.

CONCLUSIONS

Low birth weight neonates receiving KMC showed optimal thermoregulation, whereas a high incidence of moderate hypothermia was seen among neonates receiving conventional care during transport.

Father newborn skin-to-skin wheelchair transfer from delivery room to neonatal care unit: Possible change in practices

OBJECTIVE

To evaluate the transfer of newborns from the delivery room to the neonatal care unit with their fathers on wheelchairs in terms of the safety of the procedure and paternal anxiety.

METHODS

A prospective observational single-center before-and-after pilot study was conducted from February to May 2018 at the University Maternity Hospital of Nantes. Safe transfer was judged on the basis of episodes of hypothermia or hypoglycemia. Paternal anxiety was assessed with the State-Trait Anxiety Inventory (STAI) scale after newborn transfer.

RESULTS

Overall, 70 preterm newborns were enrolled, 44 were carried in wheelchairs in the father's arms (target group) and 26 were transferred in an incubator (control group). After adjusting for gestational age and birthweight, there were no statistically significantly differences between the target and the control group in the rates of hypothermia (43.9% vs 30.8%, p = 0,59) and hypoglycemia (9.52% vs 19.23%, p = 0,19). The STAI scale score was not significantly different between groups after incubator transfer or wheelchair transfer, at 35 ± 8.2 and 38 ± 10.2, respectively (p = 0.07).

CONCLUSION

Transferring a newborn to the neonatal care unit via wheelchair with the father is a safe alternative to incubator transfer.