The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approach

Abstract Objective This study aimed to investigate the perceived safety during the transfer process of infants from a Neonatal Intensive Care Unit (NICU) to a regional level II department. It sought to identify stakeholder agreements and divergences on safety and to determine the facilitators and ba...

Full description

Saved in:
Bibliographic Details
Main Authors: Karen de Bijl-Marcus, Fenna Mossel, Kees Ahaus, Bettine Pluut, Manon Benders, Arjan Bruintjes, Martina Buljac-Samardzic
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Pediatrics
Subjects:
Online Access:https://doi.org/10.1186/s12887-025-05537-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850094719614320640
author Karen de Bijl-Marcus
Fenna Mossel
Kees Ahaus
Bettine Pluut
Manon Benders
Arjan Bruintjes
Martina Buljac-Samardzic
author_facet Karen de Bijl-Marcus
Fenna Mossel
Kees Ahaus
Bettine Pluut
Manon Benders
Arjan Bruintjes
Martina Buljac-Samardzic
author_sort Karen de Bijl-Marcus
collection DOAJ
description Abstract Objective This study aimed to investigate the perceived safety during the transfer process of infants from a Neonatal Intensive Care Unit (NICU) to a regional level II department. It sought to identify stakeholder agreements and divergences on safety and to determine the facilitators and barriers to achieving a high level of perceived safety. Design This study employed a mixed-method cohort design and action research approach grounded in Safety-II principles. Setting The study focused on transfers from a single Dutch university hospital NICU to multiple regional level II neonatology departments. Methods Surveys were administered to parents and care professionals, including NICU staff, level II department staff, and ambulance personnel. The surveys consisted of both quantitative and open-ended questions. Data were analysed quantitatively and qualitatively, incorporating Safety-I and Safety-II perspectives, to assess the perceived safety and identify facilitators and barriers. Results A total of 46 transfers were evaluated by 239 stakeholders. The overall perception of safety was positive among all stakeholder groups. There were no significant differences in the overall level of perceived safety between parents and care professionals. However, stakeholder perceptions varied significantly across transfer phases. Qualitative analysis revealed facilitators and barriers related to timing, parental participation and information exchange. Conclusion This study indicated consistently positive safety perceptions among parents and care professionals. Effective communication, parental participation and optimal timing were identified as crucial for enhancing safety perceptions during transfers.
format Article
id doaj-art-c69cfabaf7014e5d81c74b9e161781a4
institution DOAJ
issn 1471-2431
language English
publishDate 2025-03-01
publisher BMC
record_format Article
series BMC Pediatrics
spelling doaj-art-c69cfabaf7014e5d81c74b9e161781a42025-08-20T02:41:36ZengBMCBMC Pediatrics1471-24312025-03-0125111010.1186/s12887-025-05537-4The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approachKaren de Bijl-Marcus0Fenna Mossel1Kees Ahaus2Bettine Pluut3Manon Benders4Arjan Bruintjes5Martina Buljac-Samardzic6Department Neonatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht UniversityPluut & PartnersDepartment Health Services Management & Organisation Erasmus School of Health Policy & Management, Erasmus University RotterdamPluut & PartnersDepartment Neonatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht UniversityRegional Ambulance Service Utrecht (RAVU)Department Health Services Management & Organisation Erasmus School of Health Policy & Management, Erasmus University RotterdamAbstract Objective This study aimed to investigate the perceived safety during the transfer process of infants from a Neonatal Intensive Care Unit (NICU) to a regional level II department. It sought to identify stakeholder agreements and divergences on safety and to determine the facilitators and barriers to achieving a high level of perceived safety. Design This study employed a mixed-method cohort design and action research approach grounded in Safety-II principles. Setting The study focused on transfers from a single Dutch university hospital NICU to multiple regional level II neonatology departments. Methods Surveys were administered to parents and care professionals, including NICU staff, level II department staff, and ambulance personnel. The surveys consisted of both quantitative and open-ended questions. Data were analysed quantitatively and qualitatively, incorporating Safety-I and Safety-II perspectives, to assess the perceived safety and identify facilitators and barriers. Results A total of 46 transfers were evaluated by 239 stakeholders. The overall perception of safety was positive among all stakeholder groups. There were no significant differences in the overall level of perceived safety between parents and care professionals. However, stakeholder perceptions varied significantly across transfer phases. Qualitative analysis revealed facilitators and barriers related to timing, parental participation and information exchange. Conclusion This study indicated consistently positive safety perceptions among parents and care professionals. Effective communication, parental participation and optimal timing were identified as crucial for enhancing safety perceptions during transfers.https://doi.org/10.1186/s12887-025-05537-4SafetyTransferSafety-IINeonatal intensive careSafety perception
spellingShingle Karen de Bijl-Marcus
Fenna Mossel
Kees Ahaus
Bettine Pluut
Manon Benders
Arjan Bruintjes
Martina Buljac-Samardzic
The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approach
BMC Pediatrics
Safety
Transfer
Safety-II
Neonatal intensive care
Safety perception
title The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approach
title_full The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approach
title_fullStr The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approach
title_full_unstemmed The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approach
title_short The perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level II neonatology department: a mixed-method cohort study using a Safety-II approach
title_sort perception of safety regarding the transfer of infants from the neonatal intensive care unit to a level ii neonatology department a mixed method cohort study using a safety ii approach
topic Safety
Transfer
Safety-II
Neonatal intensive care
Safety perception
url https://doi.org/10.1186/s12887-025-05537-4
work_keys_str_mv AT karendebijlmarcus theperceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT fennamossel theperceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT keesahaus theperceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT bettinepluut theperceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT manonbenders theperceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT arjanbruintjes theperceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT martinabuljacsamardzic theperceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT karendebijlmarcus perceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT fennamossel perceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT keesahaus perceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT bettinepluut perceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT manonbenders perceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT arjanbruintjes perceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach
AT martinabuljacsamardzic perceptionofsafetyregardingthetransferofinfantsfromtheneonatalintensivecareunittoaleveliineonatologydepartmentamixedmethodcohortstudyusingasafetyiiapproach