Scientific correspondence
Regionalisation of retinopathy of prematurity (ROP) screening
improves compliance with guidelines: an audit of ROP screening in the
Northern Region of England
N G Ziakasa, D G Cottrella, D W A Milliganb, P M Pennefathera, M A Bamashmusa, M P Clarkea
a Department of
Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK, b Department of Neonatology
Correspondence to: Mr David Cottrell, Eye Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK D.G.Cottrell{at}ncl.ac.uk
Accepted for publication 22 January 2001
AIMS
This project was
designed to determine whether a coordinated regional strategy can
improve the implementation of national guidelines for screening for
retinopathy of prematurity (ROP), and to identify causes for failure of compliance.
METHODSRetrospective
case note audit relating to two periods, 1990-1 and 1994, involving
all 17 neonatal intensive care units in the Northern Region of England.
Between the two periods, a regional strategy was instituted in an
endeavour to improve compliance. Babies born in or admitted to the
units during the study periods who were eligible for ROP screening were
included. Screening performance was assessed against a standard of
100% compliance with the guidelines. In the second audit period
compliance with subsidiary standards was also measured, and reasons for
failure were identified.
RESULTSCompliance
improved from 47% (262/558) in the first audit cycle to 73% (264/360)
in the second. Subgroup analysis in this second cycle indicated better
compliance (93.3%) in higher risk babies (
29 weeks' gestational
age). Babies transferred between units, discharged home before
screening, or who failed to qualify for screening on one of the two
defined criteria, were more likely to be missed.
CONCLUSIONA carefully
implemented regional approach to screening resulted in a higher uptake
for babies most at risk. Simple recommendations are made to achieve
further improvement in compliance with the guidelines. The wider
implications for screening in other conditions and in other areas and
specialties are highlighted.
© 2001 by British Journal of Ophthalmology
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