Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative

Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative

Blog Article

Background: Continuous positive airway pressure (CPAP) therapy is the standard of care for neonatal respiratory distress and improves survival when implemented in low-resource settings.Clinical audits at the Borama Regional Hospital (BRH) Neonatal Intensive Care Unit (NICU) revealed multiple barriers to effective CPAP, including insufficient pressure, a lack of neonatal-sized nasal prongs, and patient interface challenges.Aim: Improve respiratory distress by increasing effective CPAP delivery for neonates 30 days of age from 52% to 90% in 6 eagles head coach hoodie months.Setting: Single-centre referral hospital in the Awdal region of Somaliland.

Methods: Quality improvement (QI) initiative with outcomes displayed using statistical process control (copyright) charts.Results: Eleven residents, three medical interns and seven NICU nurses completed the educational training.Forty-five patients were initiated on the locally designed bubble CPAP (bCPAP) device with a 47% (122/261) CPAP safety checklist completion rate for the three daily nursing shifts.We achieved our study aim by increasing the adherence rate to the 7-item bCPAP device set up from a baseline of 52% to 91%.

The rate of infants weaned or discontinued from bCPAP for improved respiratory severity score (RSS) increased from 0% to 18% but did not demonstrate process change.There was no increase in adverse event rates (air leak, nasal cga 200 to cga 510 adapter columella breakdown and nasal irritation).Conclusion: We demonstrated increased effective bCPAP delivery and decreased respiratory distress.Contribution: This study outlines low-cost, customisable QI strategies to address commonly encountered gaps for effective bCPAP delivery in low-resource settings without access to commercially available CPAP devices or speciality-trained providers.