Multiparameter Continuous Physiological Monitoring Technologies in Neonates Among Health Care Providers and Caregivers at a Private Tertiary Hospital in Nairobi, Kenya: Feasibility, Usability, and Acceptability Study.

Amy Sarah Ginsburg,Jesse Coleman,William M Macharia,Dorothy Chomba,Roseline Ochieng,Jessica Rigg,Mai-Lei Woo Kinshella,J Mark Ansermino,Violet Naanyu,Bella Hwang

doi:10.2196/29755

Abstract

BackgroundContinuous physiological monitoring technologies are important for strengthening hospital care for neonates, particularly in resource-constrained settings, and understanding user perspectives is critical for informing medical technology design, development, and optimization.ObjectiveThis study aims to assess the feasibility, usability, and acceptability of 2 noninvasive, multiparameter, continuous physiological monitoring technologies for use in neonates in an African health care setting.MethodsWe assessed 2 investigational technologies from EarlySense and Sibel, compared with the reference Masimo Rad-97 technology through in-depth interviews and direct observations. A purposive sample of health care administrators, health care providers, and caregivers at Aga Khan University Hospital, a tertiary, private hospital in Nairobi, Kenya, were included. Data were analyzed using a thematic approach in NVivo 12 software.ResultsBetween July and August 2020, we interviewed 12 health care providers, 5 health care administrators, and 10 caregivers and observed the monitoring of 12 neonates. Staffing and maintenance of training in neonatal units are important feasibility considerations, and simple training requirements support the feasibility of the investigational technologies. Key usability characteristics included ease of use, wireless features, and reduced number of attachments connecting the neonate to the monitoring technology, which health care providers considered to increase the efficiency of care. The main factors supporting acceptability included caregiver-highlighted perceptions of neonate comfort and health care respondent technology familiarity. Concerns about the side effects of wireless connections, electromagnetic fields, and mistrust of unfamiliar technologies have emerged as possible acceptability barriers to investigational technologies.ConclusionsOverall, respondents considered the investigational technologies feasible, usable, and acceptable for the care of neonates at this health care facility. Our findings highlight the potential of different multiparameter continuous physiological monitoring technologies for use in different neonatal care settings. Simple and user-friendly technologies may help to bridge gaps in current care where there are many neonates; however, challenges in maintaining training and ensuring feasibility within resource-constrained health care settings warrant further research.International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2019-035184

Highlights

Neonatal mortality remains persistently high, with a disproportionate burden in Sub-Saharan Africa [1]
Usability, and acceptability of 2 existing noninvasive, multiparameter, continuous physiological monitoring (MCPM) technologies developed by technology developers EarlySense and Sibel for use in neonates in an African health care setting
Acceptability comprises 2 dimensions: the willingness of health care provider HCP-D (HCP) to use the technology during patient interactions and the willingness of caregivers to have the technology used with their neonates [6]

Summary

Introduction

Neonatal mortality remains persistently high, with a disproportionate burden in Sub-Saharan Africa [1]. The project seeks to boost the development and optimization of promising neonatal diagnostic and care technologies that could be applied in resource-constrained settings by establishing an Africa-based evaluation platform. This is achieved through global collaboration with partners with expertise in medical technology development and evaluation, as well as neonatal and child health. Usability, and acceptability of 2 existing noninvasive, multiparameter, continuous physiological monitoring (MCPM) technologies developed by technology developers EarlySense and Sibel for use in neonates in an African health care setting. Continuous physiological monitoring technologies are important for strengthening hospital care for neonates, in resource-constrained settings, and understanding user perspectives is critical for informing medical technology design, development, and optimization

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Conclusion