Training Hungarian neonatal transport nurses in screening for retinopathy of prematurity with telemedicine

Abstract

Remote screening for retinopathy of prematurity by wide-field digital imaging and network telemedicine is increasingly used to prevent blindness without the unnecessary transport of infants. Our purpose was to train and license dedicated neonatal transport nurses to do this in Hungary. We developed a complex, four-step curriculum in mobile retinotelemetry. Using a robust selection process, we invited eight transport nurses (NtNP/RtN) to receive training during the 2008–2017 project. The curriculum started with the basics of ophthalmology. Using an artificial eye, it continued with the theory and practice of ophthalmologic exams. Then, supervised by an ophthalmologist, each nurse performed 50 video recordings of anaesthetized and non-anaesthetized infants. After demonstrating their competence, five of the eight candidate nurses received a license for retinotelemetry. During their subsequent practice, they had to undergo case reviews half-yearly by a specialist and renew their license every 2–3 years. During the 2008–2016 period, we analysed 7,177 remote screenings from a training perspective. During January 1–August 31 in 2017 period, we analysed extra data from 795 remote screenings of 332 infants from specific prevention perspectives. With the cooperation of preexisting neonatal transport service and the ophthalmological reading centre of a university hospital, a mobile telemedicine screening network was successfully developed in Hungary. Our results demonstrate how retinotelemetry can support different levels of prevention medicine. The network should work effectively and efficiently with continuous professional development.