Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 19, 2021
Date Accepted: Jul 27, 2021
Feasibility, usability, and acceptability of multiparameter continuous physiological monitoring technologies in neonates among healthcare providers and caregivers at a private tertiary hospital in Nairobi, Kenya: A qualitative study
ABSTRACT
Background:
Continuous physiological monitoring technologies are important to strengthening hospital care for neonates, particularly in resource-constrained settings, and understanding user perspectives is critical to informing medical technology design, development, and optimization.
Objective:
To assess the feasibility, usability, and acceptability of two non-invasive, multiparameter, continuous physiological monitoring technologies for use in neonates in an African healthcare setting.
Methods:
We assessed two investigational technologies from EarlySense and Sibel compared to the reference Masimo Rad-97 technology through in-depth interviews and direct observations. A purposeful sample of healthcare administrators, healthcare 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.
Results:
Between July and August 2020, we interviewed 12 healthcare providers, five healthcare administrators, and 10 caregivers, and observed the monitoring of 12 neonates. Staffing and maintenance of training in neonatal units were important feasibility considerations and simple training requirements supported 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 was considered to increase efficiency of care. Major factors supporting acceptability included caregiver-highlighted perceptions of neonate comfort and healthcare respondent technology familiarity. Concerns about side effects from wireless connections and electromagnetic fields and mistrust of unfamiliar technologies emerged as possible barriers to acceptance of the investigational technologies.
Conclusions:
Overall, respondents considered the investigational technologies feasible, usable and acceptable for the care of neonates at this healthcare 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 healthcare settings warrants further research. Clinical Trial: NCT03920761
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