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Electronic application to improve management of infections in low-income neonatal units: pilot implementation of the NeoTree beta app in a public sector hospital in Zimbabwe

Abstract:
There are 2. 4 million annual neonatal deaths worldwide. Simple, evidence-based interventions such as temperature control could prevent approximately two-thirds of these deaths. However, key problems in implementing these interventions are a lack of newborn-trained healthcare workers and a lack of data collection systems. NeoTree is a digital platform aiming to improve newborn care in low-resource settings through real-time data capture and feedback alongside education and data linkage. This project demonstrates proof of concept of the NeoTree as a real-time data capture tool replacing handwritten clinical paper notes over a 9-month period in a tertiary neonatal unit at Harare Central Hospital, Zimbabwe. We aimed to deliver robust data for monthly mortality and morbidity meetings and to improve turnaround time for blood culture results among other quality improvement indicators. There were 3222 admissions and discharges entered using the NeoTree software with 41 junior doctors and 9 laboratory staff trained over the 9-month period. The NeoTree app was fully integrated into the department for all admission and discharge documentation and the monthly presentations became routine, informing local practice. An essential factor for this success was local buy-in and ownership at each stage of the project development, as was monthly data analysis and presentations allowing us to rapidly troubleshoot emerging issues. However, the laboratory arm of the project was negatively affected by nationwide economic upheaval. Our successes and challenges piloting this digital tool have provided key insights for effective future roll-out in Zimbabwe and other low-income healthcare settings.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjoq-2020-001043

Authors


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Role:
Author
ORCID:
0000-0002-5726-2752
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Institution:
University of Oxford
Department:
ZOOLOGY
Sub department:
AT ZOOLOGY; HB NDM EXPERIMENTAL MEDICINE
Role:
Author


Publisher:
BMJ Publishing Group
Journal:
BMJ Open Quality More from this journal
Volume:
10
Issue:
1
Article number:
e001043
Place of publication:
England
Publication date:
2021-01-20
Acceptance date:
2021-01-10
DOI:
EISSN:
2399-6641
Pmid:
33472853


Language:
English
Keywords:
Pubs id:
1158777
Local pid:
pubs:1158777
Deposit date:
2021-01-27

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