title: An analysis of inter-healthcare facility transfer of neonates within the eThekwini Health District of KwaZulu-Natal, South Africa.
abstract: OBJECTIVE
  To investigate delays in the transfer of neonates between healthcare facilities and to detect any adverse events encountered during neonatal transfer.
  
  
  METHODS
  A prospective study was conducted from December 2011 to January 2012. A quantitative, non-experimental design was used to undertake a descriptive analysis of 120 inter-healthcare facility transfers of neonates within the eThekwini Health District (Durban) of KwaZulu-Natal Province, South Africa. Data collection was via questionnaire. Data collection was restricted to the Emergency Medical Services (EMSs) of eThekwini Health District, which is the local public ambulance provider.
  
  
  RESULTS
  All transfers were undertaken by road ambulances: 83 (62.2%) by frontline ambulances; 35 (29.2%) by the obstetric unit; and 2 (1.7%) by the planned patient transport vehicles. Twenty-nine (24.2%) transfers involved critically ill neonates. The mean (standard deviation (SD)) time to complete an inter-healthcare facility transfer was 3 h 49 min (1 h 57 min) (range 0 h 55 min - 10 h 34 min). Problems with transfer equipment were common due to poor resource allocation, malfunctioning equipment, inappropriate equipment for the type of transfer and dirty or unsterile equipment. The study identified 10 (8.3%) physiologically related adverse events, which included 1 (0.8%) death plus a further 18 (15.0%) equipment-related adverse events.
  
  
  CONCLUSIONS
  EMS is involved in transporting a significant number of intensive care and non-intensive care neonates between healthcare facilities. This study has identified numerous factors affecting the efficiency of inter-facility transfer of neonates and highlights a number of areas requiring improvement.
authors.affiliation: Department of Emergency Medical Care and Rescue, Durban University of Technology, South Africa; KwaZulu-Natal Emergency Medical Services, Durban, South Africa. bat.coomar@gmail.com.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Ashokcoomar
authors.forename: Raveen
authors.initials: R
authors.lastname: Naidoo