Development of capability lists for neonatal critical care at three levels in China: a modified Delphi study
Background The standardised management of neonatal critical care centres can help improve health outcomes of vulnerable newborns. Guidance is required to update evidence related to construction and management of neonatal critical care centres in China.Objective To establish expert consensus on the e...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/8/1/e002441.full |
| _version_ | 1797227639042211840 |
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| author | Lei Li Yanping Zhang Ting Li Qian Zhang Xing Li Shan Zhang Qiuping Li Lu Zhuang Zhichun Feng Pengpeng Li Xiangyong Kong |
| author_facet | Lei Li Yanping Zhang Ting Li Qian Zhang Xing Li Shan Zhang Qiuping Li Lu Zhuang Zhichun Feng Pengpeng Li Xiangyong Kong |
| author_sort | Lei Li |
| collection | DOAJ |
| description | Background The standardised management of neonatal critical care centres can help improve health outcomes of vulnerable newborns. Guidance is required to update evidence related to construction and management of neonatal critical care centres in China.Objective To establish expert consensus on the essential capability lists for neonatal critical care at three levels in China.Design and setting According to China’s administrative divisions, the Chinese guidelines stratifies neonatal critical care into three levels: county level (basic and special care), city level (intensive care) and province level (comprehensive care including neonatal surgery and more subspecialty interventions). A modified Delphi study was conducted. A group of 20 neonatologists from the Chinese Association of Neonatologists rated the importance of capability items on a 5-point Likert scale.Results At county level, the list consisted of 29 items related to basic and special care, and 3 items were unanimously rated very important by all experts: neonatal resuscitation, endotracheal intubation and continuous positive airway pressure ≥72 hours. At city level, group consensus defined 38 items as essential. Besides the essential items of county level, more items for intensive care were included in city level. At province level, 64 items reached consensus, including neonatal surgery and more advanced subspecialty interventions. The Kendall’s W values showed good agreement among experts in both rounds, and an increase from round 1 to round 2.Conclusions We developed the capability lists for neonatal critical care at three levels in China. Neonatal resuscitation should be provided by all levels. Interventions for preterm newborns are stratified according to gestational age and birth weight. Congenital abnormalities requiring surgical services need to be managed in high-level centres. |
| first_indexed | 2024-04-24T14:44:00Z |
| format | Article |
| id | doaj.art-8b639c2840a34591bc51ffa7c45124a1 |
| institution | Directory Open Access Journal |
| issn | 2399-9772 |
| language | English |
| last_indexed | 2024-04-24T14:44:00Z |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj.art-8b639c2840a34591bc51ffa7c45124a12024-04-02T20:15:08ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722024-03-018110.1136/bmjpo-2023-002441Development of capability lists for neonatal critical care at three levels in China: a modified Delphi studyLei Li0Yanping Zhang1Ting Li2Qian Zhang3Xing Li4Shan Zhang5Qiuping Li6Lu Zhuang7Zhichun Feng8Pengpeng Li9Xiangyong Kong101Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric and Gynecologic Diseases, State Key Laboratory for Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China2 Department of Infectious Diseases, Tianjin Medical University General Hospital, Tianjin, China13 First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, ChinaHepatobiliary/Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Transplantation, Chinese Academy of Medical Sciences, Nanjing, Jiangsu, ChinaSchool of Nursing, Anhui Medical University, Hefei, Anhui, ChinaSchool of Public Health, Capital Medical University, Beijing, ChinaThe Seventh Medical Centre of Chinese PLA General Hospital, Beijing, ChinaDepartment of Neonatology, Faculty of Pediatrics, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing Key Laboratory of Pediatric Organ Failure, The Seventh Medical Center of PLA General Hospital, Beijing, ChinaThe Seventh Medical Centre of Chinese PLA General Hospital, Beijing, ChinaDepartment of Neonatology, Faculty of Pediatrics, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing Key Laboratory of Pediatric Organ Failure, The Seventh Medical Center of PLA General Hospital, Beijing, ChinaDepartment of Neonatology, Faculty of Pediatrics, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing Key Laboratory of Pediatric Organ Failure, The Seventh Medical Center of PLA General Hospital, Beijing, ChinaBackground The standardised management of neonatal critical care centres can help improve health outcomes of vulnerable newborns. Guidance is required to update evidence related to construction and management of neonatal critical care centres in China.Objective To establish expert consensus on the essential capability lists for neonatal critical care at three levels in China.Design and setting According to China’s administrative divisions, the Chinese guidelines stratifies neonatal critical care into three levels: county level (basic and special care), city level (intensive care) and province level (comprehensive care including neonatal surgery and more subspecialty interventions). A modified Delphi study was conducted. A group of 20 neonatologists from the Chinese Association of Neonatologists rated the importance of capability items on a 5-point Likert scale.Results At county level, the list consisted of 29 items related to basic and special care, and 3 items were unanimously rated very important by all experts: neonatal resuscitation, endotracheal intubation and continuous positive airway pressure ≥72 hours. At city level, group consensus defined 38 items as essential. Besides the essential items of county level, more items for intensive care were included in city level. At province level, 64 items reached consensus, including neonatal surgery and more advanced subspecialty interventions. The Kendall’s W values showed good agreement among experts in both rounds, and an increase from round 1 to round 2.Conclusions We developed the capability lists for neonatal critical care at three levels in China. Neonatal resuscitation should be provided by all levels. Interventions for preterm newborns are stratified according to gestational age and birth weight. Congenital abnormalities requiring surgical services need to be managed in high-level centres.https://bmjpaedsopen.bmj.com/content/8/1/e002441.full |
| spellingShingle | Lei Li Yanping Zhang Ting Li Qian Zhang Xing Li Shan Zhang Qiuping Li Lu Zhuang Zhichun Feng Pengpeng Li Xiangyong Kong Development of capability lists for neonatal critical care at three levels in China: a modified Delphi study BMJ Paediatrics Open |
| title | Development of capability lists for neonatal critical care at three levels in China: a modified Delphi study |
| title_full | Development of capability lists for neonatal critical care at three levels in China: a modified Delphi study |
| title_fullStr | Development of capability lists for neonatal critical care at three levels in China: a modified Delphi study |
| title_full_unstemmed | Development of capability lists for neonatal critical care at three levels in China: a modified Delphi study |
| title_short | Development of capability lists for neonatal critical care at three levels in China: a modified Delphi study |
| title_sort | development of capability lists for neonatal critical care at three levels in china a modified delphi study |
| url | https://bmjpaedsopen.bmj.com/content/8/1/e002441.full |
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