Intrahospital neonatal transport at Muhima District Hospital, Kigali, Rwanda

Abstract

Introduction:effective neonatal transport is crucial to survival and good outcomes of referred preterm and sick neonates. Critically ill infants are a vulnerable population and are at high risk for adverse effects during transport; therefore, it must be done in strict safest way possible. Neonatal transport is not well established in low-income countries and is likely contributing to the high neonatal mortality rates. In Rwanda, there is no information on intrahospital neonatal transport. Purpose: This study aims to assess intrahospital neonatal transport and infant’s stability upon admission to the Neonatal Intensive Care Unit (NICU) at Muhima District Hospital (MDH) in Kigali, Rwanda. Methodology: A descriptive cross-sectional study design were used. A totality of 92 neonates who met inclusion criteria were enrolled in this study by using a convenience sampling strategy. An observational checklist was used for data collection. Data analysis was done by using descriptive statistics and Chi-square test. Results: Out of 92 transported neonates; 60% didn’t receive any pre-transport care, 38% of neonates were transported without communicating with the receiving unit.Transport incubator, radiant warmer, and portable oxygen cylinder were not used during transport; 92.4% of neonates were carried in arms and 7.6% were transported in kangaroo mother care(KMC); means of transport were statistically associated with hypothermia on admission. Hypothermia was the most clinical adverse to be present at 52.2%, followed by poor perfusion in 41.3%, tachypnea in 39.1, hypoxia in 32% and hypoglycemia in 27%. Conclusion and recommendation:The practice of intrahospital neonatal transport was not appropriate and associated with altered infant’s clinical status ; therefore is recommended to establish a neonatal transport system by elaborating policies, protocols, and guidelines. Given a resource-limited settings use of KMC to transport neonates is highly recommended and training of staffs is required. Availability of appropriate medical equipment is recommended