Revolutionizing Neonatal Transport Part 1- History

Revolutionizing Neonatal Transport- Where do we find ourselves?

As neonatal intensive care nurses and nurse practitioners, how often do we reevaulate where our critical care transport programs stand in relation to others worldwide? Current research in NICUs across the nation focuses on new medications, treatments for old trolls such as chronic lung disease, RDS, necrotizing enterocolitis, kangaroo care, etc etc...but barely a mention of transports.

In performing a review of literature for an upcoming manuscript of mine, the lack of evidence based research, protocols and nursing-contributed research was appalling. Thousands of neonatal transports both air and ground, acute and reverse occur each day in the US. As the prematurity rate climbs past 12%, we find ourselves increasing taking to the skies and roads, retrieving more and more patients from outlying facilities.

Since the advent of regionalization in the late 1980s, where neonatal care became concentrated in academic centers in urban areas, neonatology has seen a trend to the deregionalization of neonatal care, where outlying level I-II facilities are holding on to their perinatal patients as reimbursement funds grow tight, and an influx of newly minted neonatal providers migrate away from regional centers and establish units outside the regional safety net. This has resulted in an increase in the number and acuity of infants retrieved from outlying centers and transported to a regional center. Unfortunately, our knowledge base and evidence-based practice guidelines in regards to transport have not improved along the way.

There is a critical need for NICU providers and anyone involved with transport to continually utilize and contribute to the information available surrounding neonatal transport.

My next article will focus on transport triage/interfacility communication, transport leadership. and the ideal configuration of the transport team.

Stay tuned!