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Oxygen delivery and monitoring in neonatal intensive care units in Mexico in 2011 and in 2023: an observational longitudinal study.
Zepeda Romero, Luz Consuelo; Ibarra, Daniel Perez Rulfo; Leon, Juan Carlos Barrera De; Cruz, Valeria Alejandra Salas; Bouzo, David Blanco; Padilla, Jose Alfonso Gutierrez; Gilbert, Clare.
Afiliação
  • Zepeda Romero LC; Neonatal Ophtalmology, Pediatric Surgery, Hospital Civil de Guadalajara, University Center of Health Sciences, University of Guadalajara, Zapopan, Jalisco, Mexico. drconsuelo@yahoo.com.
  • Ibarra DPR; Departamento de Reproduccion Humana, Crecimiento y Desarrollo, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco, Mexico.
  • Leon JCB; Departamento de Pediatría, Hospital Materno Infantil Esperanza Lopez Mateos, Secretaria de Salud Jaisco, Zapopan, Jalisco, Mexico.
  • Cruz VAS; Departamento de Salud, Centro Universitario Los Valles, Universidad de Guadalajara, Ameca, Jalisco, Mexico.
  • Bouzo DB; Neonatal Ophtalmology, Pediatric Surgery, Hospital Civil de Guadalajara, University Center of Health Sciences, University of Guadalajara, Zapopan, Jalisco, Mexico.
  • Padilla JAG; Neonatal Ophtalmology, Pediatric Surgery, Hospital Civil de Guadalajara, University Center of Health Sciences, University of Guadalajara, Zapopan, Jalisco, Mexico.
  • Gilbert C; División de Discipinas Clínicas, Centro Universitario de Ciencias de la Salud, Universidad De Guadalajara, Zapopan, Jalisco, Mexico.
BMC Nurs ; 23(1): 590, 2024 Aug 26.
Article em En | MEDLINE | ID: mdl-39183262
ABSTRACT

BACKGROUND:

Retinopathy of prematurity (ROP) is a leading cause of avoidable blindness in children, particularly in Latin America, where hyperoxia is a significant risk factor. This study evaluated resource availability and use for administering and monitoring supplemental oxygen in Mexico.

METHODS:

In 2011, an observational study in which 32 government neonatal intensive care units (NICUs) across Mexico were visited. Data collected included occupancy, staffing levels, and equipment to deliver and monitor supplemental oxygen. Preterm infants receiving oxygen were observed. In 2023, 13 NICUs were revisited, and similar data collected. Staffing levels were benchmarked against Argentinian and US recommendations.

RESULTS:

In 2011, only 38% of NICUs had adequate medical and staffing levels to meet recommended cot-to-staff ratios for all shifts. Staffing ratios were worse during weekends and at night than during weekdays. Only 25.5% of cots had blenders, and 80.1% had saturation monitors. 153 infants were observed 87% of whom were being monitored. Upper and lower oxygen saturations were ≥ 96% in 53%, and ≤ 89% in 8%, respectively. Alarm settings were inadequate, as 38% and 32% of upper and lower alarms were switched off and 16% and 53% were incorrectly set, respectively. In the 13 NICUs with data from 2011  and 2023, cot-to-staff ratios deteriorated over time, and in 2023 no unit had recommended ratios for all shifts. Equipment provision did not change, with similar proportions of babies in oxygen being monitored (79% 2011; 75% 2023). Rates of hyperoxia decreased slightly from 54% in 2011 to 49% in 2023. More upper alarms were set (46% 2011; 75% 2023), but a higher proportion were incorrectly set (52% 2011; 68% 2023).

CONCLUSIONS:

Between 2011 and 2023, cot-to-staff ratios worsened, and equipment for safe oxygen delivery and monitoring remained insufficient. Despite available monitoring equipment, oxygen saturations often exceeded recommended levels, and alarms were frequently not set or incorrectly configured. Urgent improvements are needed in healthcare workforce numbers and practices, along with ensuring adequate equipment for safe oxygen delivery.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: Mexico Idioma: En Revista: BMC Nurs Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: Mexico Idioma: En Revista: BMC Nurs Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Reino Unido