Increasing the Screening Rate of Retinopathy of Prematurity in At-Risk Newborns-An Improvement Project in Special Newborn Care Unit of a Tertiary Care Maternity Hospital in Telangana

Abstract

Introduction: Retinopathy of Prematurity (ROP) is a vasoproliferative disorder of the retinal vessels in premature neonates and is one of the leading causes of preventable blindness. The incidence of ROP across India ranges from 38% to 47%. This wide range is due to a lack of awareness among parents and a lack of high-quality care in the Special New-born Care Unit (SNCU). Paediatricians, neonatologists, and ophthalmologists play a vital role in improving the screening rate. Aim: To improve the screening rate of ROP at four weeks of age in at-risk new-borns by sensitizing paediatricians and educating neonatal nurses and parents regarding ROP from the current 38.3% to 90% within three months. Materials and Methods: The Plan Do Study Act (PDSA) quality improvement method was used for this project. It is a quality improvement (QI) study done in the SNCU of a tertiary care maternity hospital in Hyderabad. The study was done over a period of 13 months from January 2020 to February 2021. Baseline assessment was done by reviewing records and phone calls to know the baseline ROP screening rate. To improve the screening rate, we conducted periodic training of nurses, and awareness was increased among parents through audio-visual counselling, ROP posters, and timely reminders. Results: In 368 preterm babies, the ROP screening rate increased from 38.3% to 89.95% in phase 3. The knowledge in nurses’ and parent’s also increased significantly post training (p<0.05). The incidence of ROP was found to be 6.04% (20) in our study. conclusions: The Point of Care Quality Improvement (POCQI) method helped us improve the ROP screening rate tremendously without many resources. It also significantly improved the knowledge of nurses and awareness among parents. The nurses had a sense of empowerment and satisfaction and could effectively communicate with parents.