scholarly journals Pitfalls in Retinopathy of Prematurity Screening: A Qualitative Content Analysis

2021 ◽  
Author(s):  
lojain Albathi ◽  
Nourah Abouammoh ◽  
Naif Alsowaina ◽  
Hani Albalawi ◽  
Abdullah Alqahtani ◽  
...  
Keyword(s):  
Content Analysis ◽  
Retinopathy Of Prematurity ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Qualitative Content Analysis ◽  
Surgical Care ◽  
Screening Guidelines ◽  
Delayed Referral ◽  
Rop Screening

Abstract Purpose: To identify the pitfalls in retinopathy of prematurity (ROP) screening leading to advanced disease at Ministry of Health (MOH) hospitals in Saudi Arabia. Methods: A qualitative deductive content analysis was used to study the phenomena of defects in ROP screening. A retrospective review of medical records of newborns presenting to two tertiary eye care centers with advanced ROP (Stage 4 and 5) from January 2012 to June 2019 was completed. An extensive review of the original files at the referring hospitals was conducted, including the general condition and findings of ophthalmic examination and the sequence of follow-up until the infant was discharged/referred. Data analysis was completed using pre-structured categorization matrix. Results: Records of 29 infants with advanced stage ROP were identified. Only 13 medical records were available and obtained. The pitfalls in screening found in the study were failure to refer by the neonatologist, delayed follow-up by the ophthalmologist, failure to follow-up by the ophthalmologist, failure to diagnose by the ophthalmologist, poor documentation in patient files, unavailability of ophthalmologist, family negligence, lack of treatment and delayed referral to a higher center, and progression despite timely screening and management.Conclusion: Although clear ROP screening guidelines are available, implementations of these guidelines are suboptimal. This study showed the most common defect in screening is physician’s inadequacy and unavailability. A proper network of competent ROP screening physicians in all neonatal intensive care units should be established. Centers for advanced ROP surgery should be allocated to deliver a timely surgical care if needed.

scholarly journals Refining evidence-based retinopathy of prematurity screening guidelines: The SCREENROP study

2019 ◽  
Vol 25 (7) ◽  
pp. 455-466
Author(s):  
Kourosh Sabri ◽  
Sandesh Shivananda ◽  
Forough Farrokhyar ◽  
Alessandro Selvitella ◽  
Bethany Easterbrook B Kin ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Screening Criteria ◽  
Screening Guidelines ◽  
Derivation Cohort ◽  
Level 3 ◽  
Clinically Significant ◽  
Rop Screening

Abstract Purpose Retinopathy of prematurity (ROP) is a potentially blinding condition affecting premature infants for which less than 10% of babies undergoing screening require treatment. This study assessed and validated predictors of developing clinically significant ROP (type 2 or worse) and ROP requiring treatment. Design Nationwide retrospective cohort study. Methods This study included infants born between January 2014 and June 2016, admitted to level 3 neonatal intensive care units across Canada who underwent ROP screening. Data were derived from the Canadian Neonatal Network database. Predefined ≥ 1% risk for clinically significant retinopathy or prematurity and ROP requiring treatment was set as threshold for screening. Thirty-two potential predictors were analyzed, to identify and validate the most important ones for predicting clinically significant ROP. The predictors were determined on a derivation cohort and tested on a validation cohort. Multivariable logistic regression modeling was used for analysis. Results Using a sample of 4,888 babies and analyzing 32 potential predictors, capturing babies with ≥1% risk of developing clinically significant ROP equated to screening babies with birth weight (BW) <1,300 g or gestational age (GA) <30 weeks while capturing babies with ≥1% risk of requiring ROP treatment equated to screening babies with BW <1,200 g or GA <29 weeks. Conclusions The Canadian ROP screening criteria can be modified to screen babies with BW <1,200 g or GA <30 weeks. Using these criteria, babies requiring treatment would be identified while reducing the number of babies screened unnecessarily.

Retinopathy of Prematurity: An Example of a Successful Screening Program

2010 ◽  
Vol 29 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Wendy VanStone
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Multidisciplinary Approach ◽  
Screening Program ◽  
Low Birth Weight Infants ◽  
Parental Compliance ◽  
American Academy Of Pediatrics ◽  
Rop Screening

Retinopathy of prematurity (ROP) is a persistent and often devastating morbidity associated with premature and low birth weight infants. It continues to be a frequent diagnosis in the neonatal intensive care unit, despite technologic advances and increased knowledge. The American Academy of Pediatrics (AAP) has issued practice guideline recommendations for ROP screening and treatment that aid in creating a consistent and reliable ROP protocol. Challenges exist in screening for and treating ROP, including delayed or omitted exams, lack of qualified examiners, lack of parental compliance with follow-up care, and fear of litigation. This article provides a detailed example of a successful ROP program based on the AAP recommendations and utilizing a multidisciplinary approach to ensure optimal ROP care for the preterm infant. It also discusses the role of the ROP coordinator assigned to the NICU.

Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

2020 ◽  
pp. bjophthalmol-2020-316401
Author(s):  
Qian Yang ◽  
Xiaohong Zhou ◽  
Yingqin Ni ◽  
Haidong Shan ◽  
Wenjing Shi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Predictive Performance ◽  
Screening Guideline ◽  
Postmenstrual Age ◽  
The Mean ◽  
Type 1 Rop ◽  
Rop Screening

PurposesTo develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).MethodsA multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.ResultsOf the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.ConclusionsThe incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.

Retinopathy of Prematurity—Using Electronic Medical Records to Efficiently Follow Patients at Multiple Hospitals

2021 ◽  
pp. 097321792110076
Author(s):  
Gwendolyn Schultz ◽  
Majida Gaffar
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Transitional Period ◽  
Neonatal Intensive Care Units ◽  
American Academy Of Pediatrics ◽  
Time Period ◽  
Cost Efficient ◽  
Delay Of Care ◽  
Physician Scheduling ◽  
Rop Screening

Purpose: To report the use of a centralized electronic medical record (EMR) to provide timely retinopathy of prematurity (ROP) screening in a previously fragmented monitoring system in a standalone children’s hospital in Connecticut. Methods: A chart review of 306 visits for ROP screening in 3 neonatal intensive care units (NICUs) over a time period of 24 months. Results: All infants born at <30 weeks gestational age or birth weight <1,500g (N = 107) at these NICUs were screened for ROP according to the American Academy of Pediatrics guidelines. Data was collected before the implementation of our centralized EMR list, during a transitional period, and once the list was established. Our analysis of the data found an improvement in delay of care from 16.85% to 10.83% of visits, and a decrease in number of visits done during off hours from 20.4% to 5% of visits. Conclusion: Our tool was a free and cost-efficient centralization of a once difficult-to-manage process for ROP screenings in Connecticut. The decrease in delay of care and improvement in physician scheduling will lead to better outcomes for our patients and better sustainability of practice for our providers.

scholarly journals Pitfalls of Advanced Retinopathy of Prematurity Presentation: A Content Analysis of Medical Records

2021 ◽  
Vol Volume 14 ◽  
pp. 3873-3882
Author(s):  
Lojain AlBathi ◽  
Noura Abouammoh ◽  
Nayef AlSwaina ◽  
Hani B AlBalawi ◽  
Abdullah A Al Qahtani ◽  
...  
Keyword(s):  
Content Analysis ◽  
Retinopathy Of Prematurity ◽  
Medical Records

scholarly journals A Qualitative Analysis of Challenges and Successes in Retinopathy of Prematurity Screening

2018 ◽  
Vol 08 (02) ◽  
pp. e128-e133 ◽  
Author(s):  
Lisa Bain ◽  
Alexandria Kristensen-Cabrera ◽  
Henry Lee
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Thematic Analysis ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Quality Care ◽  
Common Theme ◽  
Key Factors ◽  
Culture Education ◽  
Rop Screening

Objective The objective of this study is to identify characteristics of neonatal intensive care unit (NICU) practice that influence successful retinopathy of prematurity (ROP) screening. Study Design In this qualitative study, top, improved, and bottom performing NICUs in the California Perinatal Quality Care Collaborative were identified based on ROP screening rates and invited to participate. NICU personnel were interviewed using a semistructured questionnaire. Using thematic analysis, key factors that influence ROP screening were identified. Results Themes found in top performing hospitals include a commitment to quality improvement, a committed ophthalmologist, and a system of double checks. Improved NICUs had a common theme of utilizing telemedicine for exams and identification of eligible neonates on admission. The bottom performing hospital struggled with education and identification of eligible neonates and a lack of a dedicated ophthalmologist. Conclusion Structure, culture, education, and commitment all contribute to the success of ROP screening in the NICU.

scholarly journals Parents’ Perceptions Regarding Readiness for Their Infant’s Discharge from the NICU

2013 ◽  
Vol 32 (5) ◽  
pp. 324-334 ◽  
Author(s):  
Natasha Burnham ◽  
Nancy Feeley ◽  
Kathyrn Sherrard
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Qualitative Content Analysis ◽  
Hands On ◽  
Need For Information

Purpose: To identify what parents need to feel ready for the discharge of their infant from the neonatal intensive care unit (NICU).Design: Qualitative.Sample: 20 parents of infants admitted to a Canadian Level III NICU were interviewed (2011–2012) and asked to identify what they require to feel ready for discharge. Interview transcripts underwent qualitative content analysis to produce a descriptive summary of parents’ perceptions of their needs.Results: Parents indicated a need for information and hands-on experience to enhance their readiness for discharge. Observations of their infant and of the NICU environment impacted parents’ perceptions of their infant’s readiness for discharge, which influenced perceptions of their own readiness for discharge. Finally, parents require tailoring of information and experiences to meet the unique needs of their family.

scholarly journals Peripheral optical coherence tomography assisted by scleral depression in retinopathy of prematurity

2021 ◽  
Author(s):  
Brittni A. Scruggs ◽  
Shuibin Ni ◽  
Thanh-Tin P. Nguyen ◽  
Susan Ostmo ◽  
Michael F. Chiang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Peripheral Retina ◽  
Optical Coherence ◽  
Rapid Acquisition ◽  
Study Participants ◽  
Rop Screening

Objective: To determine whether handheld widefield optical coherence tomography (OCT) can be used to document retinopathy of prematurity (ROP) stage while using scleral depression to improve peripheral views. Design: Prospective observational study. Participants: Consecutive neonates admitted to the neonatal intensive care unit (NICU) in a single academic medical center who also met criteria for ROP screening and consented for research imaging. Methods: Scleral depression was combined with widefield OCT using an investigational 400-kHz, 55-degree field of view handheld OCT during ROP screening from October 28, 2020 to March 03, 2021. Main Outcome Measures: Acquisition of en face and B-scan imaging of the peripheral retina to objectively assess early vitreoretinal pathology, including the demarcation between vascularized and anterior avascular retina, the presence of early ridge formation, and small neovascular tufts. Results: Various stages of ROP were detected using a rapid acquisition OCT system. In one neonate, serial OCT imaging over a five-week period demonstrated accumulation of neovascular tufts with progression to stage 3 ROP with extraretinal fibrovascular proliferation along the ridge. Videography of this technique is included in this report for instructional purposes. Conclusions: Serial examinations using widefield OCT and scleral depression may improve detection and documentation of ROP disease progression. Earlier detection of ROP-related proliferation may prevent vitreoretinal traction, retinal detachment, and blindness.

scholarly journals Erfaringer fra lærings- og mestringskurs for foreldre til premature barn

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Nina Bøhle Cheetham ◽  
Tove Aminda Hanssen
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Parent Education ◽  
Neonatal Intensive Care ◽  
Transition To School ◽  
Future Challenges ◽  
Evaluation Survey

Experiences with parent education for parents of premature childrenThe Neonatal Intensive Care Unit and the Learning and mastery center (LMS)/UNN has since 2004 offered parent education on topics as interaction, play, communication and feeding challenges as well as exchange of experience. The aim of this study is to systemize and analyze feedback from parents who have attended the courses. The study has a descriptive design. The selection are course attenders at LMS courses from 2006–2012. An evaluation survey was distributed through Quest back. Data were analyzed through SPSS. Open answers were analyzed through content analysis. A total of 56 persons participated. The majority (86%) reported satisfaction with the themes and 46% reported change in lifestyle. Meeting other parents was reported as useful. Some wished for an increased focus on topics like transition to school and daycare and on future challenges. Some suggested parent education as standard follow up. Parent education seems to meet expectations and the adjustments of the courses seem to have been successful. Feedback from parents suggests a need for more follow up.

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