Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative
African Journal of Primary Health Care & Family Medicine
| Field | Value | |
| Title | Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative | |
| Creator | Mahmoud, Hawa D. Kent, Sarah C. Ibrahim, Fatima E. Mohamed, Najma Abdulahi, Fatima A. O'Neal, Meagan N. Kanajam, Priya Diego, Ellen K. | |
| Description | 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 months.Setting: Single-centre referral hospital in the Awdal region of Somaliland.Methods: Quality improvement (QI) initiative with outcomes displayed using statistical process control (SPC) 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 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. | |
| Publisher | AOSIS | |
| Date | 2025-04-23 | |
| Identifier | 10.4102/phcfm.v17i1.4742 | |
| Source | African Journal of Primary Health Care & Family Medicine; Vol 17, No 1 (2025); 14 pages 2071-2936 2071-2928 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://phcfm.org/index.php/phcfm/article/view/4742/8148
https://phcfm.org/index.php/phcfm/article/view/4742/8149
https://phcfm.org/index.php/phcfm/article/view/4742/8150
https://phcfm.org/index.php/phcfm/article/view/4742/8152
https://phcfm.org/index.php/phcfm/article/view/4742/8151
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