Knowledge, practices, and challenges among neonatal intensive care unit nurses in retinopathy of prematurity screening: A comparative study of on-site versus telemedicine-based screening approaches

Purpose: To evaluate the knowledge, practices, and perceived challenges of neonatal intensive care unit (NICU) nurses in retinopathy of prematurity (ROP) screening and to compare findings between on-site and telemedicine-based models in tertiary hospitals in Mumbai. Methods: A cross-sectional observational survey was conducted among 54 NICU nurses across six tertiary care hospitals with either on-site ophthalmologist-led or telemedicine-based ROP screening. A structured, validated questionnaire adapted from previous studies and aligned with national ROP guidelines was used. Domains included demographics, ROP knowledge, oxygen management, parental education, documentation, and telemedicine challenges. Knowledge was assessed through multiple-choice questions and categorized as good (>75%), moderate (50–75%), or poor (<50%). Data were analyzed using descriptive statistics and Chi-square tests. Results: The mean age was 36.1 ± 9.5 years; 90.7% were females, and 87% held a diploma in nursing. Overall, 12.9% demonstrated good knowledge, 48.2% moderate knowledge, and 38.9% poor knowledge. No significant difference was observed between screening models ( P = 0.96). However, greater NICU experience was significantly associated with better knowledge ( P = 0.010). While 83.3% adhered to oxygen saturation targets and 96.3% used continuous oximetry, only 35% had formal oxygen training. Parental education was routinely provided by 51.9%, and 66.7% maintained ROP documentation—mostly paper-based. Telemedicine-specific challenges included lack of trained personnel (41%) and difficulty imaging intubated infants (52.9%). Conclusion: Regardless of screening model, gaps in NICU nurses’ ROP knowledge persist, highlighting the need for structured training and greater nursing involvement to optimize ROP care.