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Prototype expert system to assist with the stabilization of neonates prior to transport
1College of Nursing, University of Utah, Salt Lake City, USA.
Insights
A new computerized system, "The S.T.A.B.L.E. Assistant," helps stabilize sick newborns for transport. This decision support tool provides crucial guidance for community hospitals, ensuring infants receive necessary care.
Area of Science:
- Neonatal care and transport
- Clinical decision support systems
- Medical informatics
Background:
- Transporting sick or premature newborns to specialized facilities is critical for optimal care.
- Effective stabilization prior to transport is essential for infant outcomes.
- Community hospitals may lack specialized knowledge for neonatal stabilization.
Purpose of the Study:
- To introduce and evaluate "The S.T.A.B.L.E. Assistant," a prototype rule-based decision support system.
- To assess the system's ability to provide safe and guideline-adherent stabilization instructions for neonatal transport.
- To determine if the system's recommendations are within the scope of practice for community hospital caregivers.
Main Methods:
- The S.T.A.B.L.E. Assistant prototype was developed based on the "Transporting Newborns the S.T.A.B.L.E. Way" educational program.
- The system accepts infant clinical data (breathing, blood glucose, lab values) to generate stabilization instructions.
- A retrospective evaluation used data from 19 neonatal transport cases; instructions were reviewed by neonatology and transport experts for safety, guideline adherence, and scope of practice.
Main Results:
- Expert reviewers found the S.T.A.B.L.E. Assistant prototype to be safe.
- The system's generated instructions aligned with the established S.T.A.B.L.E. educational program guidelines.
- The recommended interventions were deemed appropriate for community caregivers.
Conclusions:
- The S.T.A.B.L.E. Assistant prototype demonstrates safety and adherence to clinical guidelines for neonatal transport preparation.
- The system effectively supports community hospital caregivers in stabilizing infants for transfer to tertiary care centers.
- This decision support tool has the potential to improve the quality and consistency of neonatal care during transport.
Abstract:
The transport of sick or premature newborns from community hospitals to acute care facilities is often necessary for the infants to receive the level of care required. Prior stabilization of these infants is imperative to a successful transport. The knowledge required to treat and stabilize sick and premature newborns is specialized and may not be available in community hospitals. "The S.T.A.B.L.E. Assistant" is a prototype rule based decision support system based on the educational program "Transporting Newborns the S.T.A.B.L.E. Way". "The S.T.A.B.L.E. Assistant" accepts clinical information related to an infant's breathing status, blood glucose status and selected lab values and provides instructions as to what interventions are needed to stabilize and prepare the infant for transport. The computerized program was evaluated using data collected from 19 charts of newborns requiring transport from a community hospital to a tertiary care center. Patient data were entered into the computerized program and the subsequent instructions were reviewed by a group of neonatology and neonatal transport experts. Reviewers evaluated "The S.T.A.B.L.E. Assistant" for the safety of the program, the extent to which the computerized program follows the educational program guidelines and the degree to which the instructions generated are within the scope of community caregivers' practice. Results were positive, indicating "The S.T.A.B.L.E. Assistant" prototype is safe, and within the guidelines of neonatal clinical practice.