Authors
Jourdain G, Simeoni U, Schlembach D, Bernloehr A, Cetin I, Gente M, Grosek S, Leslie A, Ratnavel N, Roth-Kleiner M
Authors
Jourdain G, Simeoni U, Schlembach D, Bernloehr A, Cetin I, Gente M, Grosek S, Leslie A, Ratnavel N, Roth-Kleiner M
Healthcare professionals, neonatal units, hospitals, health services, and regional neonatal transport services
Infants are transferred by a dedicated, specialised medical service that offers a quality of care similar to that promoted in a NICU.
The regional organisation of perinatal care based on primary, secondary and tertiary care (see TEG Birth & transfer) mandates the provision of infant transport services to facilitate the flow of patients through the system when antenatal transfer is impossible. (1) Neonatal transport is a critical phase of perinatal care, with specific needs for a specialised team and equipment to ensure maximal safety and efficiency. (2–5) Consensus guidelines and recommendations are proposed by healthcare professionals on paediatric and neonatal inter-facility transport. (1) Efficiency of specialised paediatric and neonatal transport has been evaluated in several studies. (6–15) When an infant no longer needs higher levels of care, a transfer to a hospital closer to the family’s home is recommended. This also optimises the use of available cots for all levels of care and allows the local hospital staff to familiarise themselves with the patient who will be followed up locally.
A standard detailing facilities and capabilities of transport services in the special environment of an ambulance, helicopter or fixed wing aircraft is thus needed throughout Europe.
Inter-hospital communication and regulation of transfers are complex and time consuming tasks that need to be managed by a dedicated call handling/regulation centre at the regional level, covering a sufficiently large area to reach a critical volume of activity.
Intra-hospital neonatal transfer, in particular in situations where the delivery room and the NICU are not adjacent, is also critical and warrants the same standard.
Short-term benefits
Long-term benefits
Component | Grading of evidence | Indicator of meeting the standard | |
For parents and family | |||
1. | Parents and family are informed about all aspects of the transfer of the infant by healthcare professionals. | B (High quality) | Parent feedback, patient information sheet |
2. | Parents/one parent are able to accompany the infant during transfer. | B (High quality) | Parent feedback, patient information sheet |
For healthcare professionals | |||
3. | A unit guideline on neonatal transport is adhered to by all responsible healthcare professionals. | B (High quality) | Guideline |
4. | Education and training, including medical simulation training and continuous education/training, are attended by members of the transport team and for other neonatal and obstetric healthcare professionals involved in neonatal transport. (16) (see TEG Education & training) | A (Moderate quality) B (High quality) |
Guideline, training documentation |
For neonatal unit and hospital | |||
5. | A unit guideline on intra-hospital neonatal transport, including transport of newborn infants in critical conditions, as part of the hospital organisation is available and regularly updated. | B (High quality) | Guideline |
6. | Trained and experienced healthcare professionals as well as equipment resources needed for intra-hospital neonatal transport are provided. | B (High quality) | Audit report, training documentation |
7. | Education and training, including medical simulation training and continuous education/training, are attended by members of the transport team and other neonatal and obstetric healthcare professionals involved in neonatal transport. (16) (see TEG Education & training) | A (Moderate quality) B (High quality) |
Guideline, training documentation |
For health service and regional neonatal transport service | |||
8. | A regional/national guideline on inter-hospital neonatal transport is available and regularly updated. | B (High quality) | Guideline |
9. | Health service is responsible for the provision of a regional neonatal transport service allowing complete preservation of life functions, such as body temperature maintenance, haemodynamic, respiratory, neurologic, metabolic functions and sepsis management (see description). | B (Moderate quality) | Audit report |
10. | Nurse or midwife assisted neonatal transport of newborn infants who do not need medical assistance (e.g. transfer of newborn infants for step down care) is available. | B (Moderate quality) | Guideline |
11. | A unique regional call and transfer regulation center is organised and continuously available, with a dedicated call number and real time information on the available cots in primary, secondary and tertiary centres. | B (Low quality) | Audit report |
Further development | Grading of evidence | |
For parents and family | ||
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B (Low quality) | |
For healthcare professionals | ||
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A (Low quality) | |
For neonatal unit | ||
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B (High quality) | |
For hospital | ||
N/A | ||
For health service | ||
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B (Low quality) | |
Initial steps | |
For parents and family | |
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For healthcare professionals | |
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For neonatal unit | |
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For tertiary level hospital | |
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For health service and regional neonatal transport service | |
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Staff and equipment for neonatal transfers
Staff and equipment should be dedicated to undertaking neonatal transport. Vehicle for road transfer
Air transport (helicopter or fixed wing)
Equipment
Staff for transfer
November 2018 / 1st edition / next revision: 2023
Recommended citation
EFCNI, Jourdain G, Simeoni U et al. European Standards of Care for Newborn Health: Neonatal transport. 2018.