An observational study on retinopathy of prematurity in the neonatal intensive care unit at Teaching Hospital, Peradeniya, Sri Lanka

PURPOSE: To study the incidence of retinopathy of prematurity (ROP) in a neonatal intensive care unit in Croatia and obtain information on risk factors associated with ROP. There have been limited studies on ROP in Croatia where the screening for ROP and its treatment is still insufficient and not introduced in many intensive care units. MATERIAL AND METHODS: This retrospective study included 247 premature infants admitted to the neonatal intensive care unit of University Hospital Split, over a 5-year period between January 2012, and December 2016. In this paper the relationship between clinical risk factors and the development of ROP was analyzed. RESULTS: The overall incidence for ROP was 23,9 % (59 infants), for Type 1 ROP was 9,3% (23 infants); for Type 2 ROP was 14,6% (36 infants). Median gestational age (GA) and birthweight (BW) were significantly lower among infants with ROP versus those without ROP (29: 23-34 vs. 31: 23-34,p<0,001 and 1,180:630-2,000 vs. 1485:590-2000, p<0,001 respectively). Multivariate analysis showed that only BW (p=0,029) and small for gestational age (SGA) (p=0,045) predicted the development of ROP. CONCLUSION: Birth weight and small for gestational age were the most significant risk factors for developing ROP. In comparison with studies from highly developed countries, infants with a much wider range of gestational age and birth weights are developing Type 1 ROP.

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Establishment of Elements and Principles of High Reliability Organizations in Neonatal Intensive Care Unit of de Soyza Maternity Hospital, Colombo, Sri Lanka.

INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS ◽

10.47191/ijmra/v4-i9-07 ◽

2021 ◽

Vol 04 (09) ◽

Author(s):

J.L. Himali R. Wijegunasekara ◽

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Sri Lanka ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

High Reliability ◽

Maternity Hospital ◽

High Reliability Organizations ◽

Management Structure ◽

Facility Survey

Introduction: “High Reliability Organizations (HRO)” is an innovative safety management concept. An effort to transform a health care setting in Sri Lanka to a HRO – management structure is worthwhile to experience the outcomes of this model in Sri Lankan hospital context. Objective: To establish a HRO - management structure in the Neonatal Intensive Care Unit of De Soyza Maternity Hospital Colombo. Design: Pre / post interventional study design was used. Functional status of HRO structure in the NICU was assessed; using 5 HRO principles (ie. Pre occupation with failure, Resistance to simplify, Sensitivity to operations, Commitment to resilience and Deference to expertise) and 5 HRO elements (ie. Process auditing, Rewarding, Avoidance of quality degradation, Risk perception, and Command and control), at pre and post interventional levels. Methods: Practice of HRO principles was assessed using a Self - Administered Questionnaire with a rating scale, with the participation of all the NICU staff. Practice of HRO elements was assessed by a facility survey using a check list. Intervention consisted of a managerial plan with activities to establish the HRO concept. Results: Results showed a statistically significant increase of “response scores” of participants towards HRO structure and the facility survey showed the establishment of planned activities. Conclusion: It was concluded that implementation of this plan, is gradually establishing the HRO management structure in NICU of DMH.

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