The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting

Master Thesis

2022

Permanent link to this Item
Authors
Journal Title
Link to Journal
Journal ISSN
Volume Title
Publisher
Publisher
License
Series
Abstract
Background Hypoxic-Ischemic Encephalopathy (HIE) is a debilitating neurological injury at birth due to a hypoxic event. The recommended treatment is therapeutic hypothermia (TH) provided at certain neonatal facilities and should commence within the treatment window of 6 hours (1). The outborn neonates are at a disadvantage because they require timely transport to a TH-capable neonatal ICU. The study aimed to identify the perceived barriers to care of HIE neonates born outside the cooling facility within the private healthcare setting. Methods This study made use of one-on-one structured open-ended interviews that were recorded on two separate digital recording devices. All the interviews were transcribed and stored within a cloud-based secured folder. All the interviews were subjected to qualitative content analysis using dedicated qualitative software. All audio files were destroyed after transcription to ensure participant confidentiality, including participants' names and locations. Results A total of seven participants were interviewed during the data collection phase of this study. The participants were all employed in South Africa within the private healthcare system and comprised of paediatricians, neonatologists, and neonatal nursing staff. The participants represented both the referral and receiving facilities. The descriptive analysis of the data obtained showed overlapping of emerged themes, ranging in repetitive strength. During the data analysis, three main themes were identified, with other supporting themes providing additional insight: HIE recognition and decision-making, navigating the referral process, and communication barriers. Discussion Despite the availability of resources within the private healthcare system and private patient transfer services, there are perceived barriers to timely care for HIE or Birth Asphyxia (BA) neonatal patients needing an urgent interhospital transfer. This study concluded that changes within the referral system are needed to mitigate the perceived barriers to time-sensitive care. Further research is required to motivate changes and must include the roleplayers' input within the referral process to match the patient's best interest.
Description

Reference:

Collections