Abstract
The lungs of a premature neonate are susceptible to injury due to their immaturity, both biochemically and structurally. Chronic lung disease (CLD) can occur, and may be affected by the chosen device for respiratory support, which may lead to suboptimal outcomes, as well as frustration among parents and staff. Bubble Continuous Positive Airway Pressure (bCPAP) devices are re-emerging as the preferred respiratory support mode for many premature infants to avoid the harmful effects of mechanical ventilation. However, provider resistance to the change in practice remains. This quality improvement project consisted of an educationa training about bCPAP, a pre- and post-assessment of knowledge, and a new evidence-based guideline of care with recommendations for the use of bCPAP and respiratory management in premature infants born < 30 weeks gestational age. The outcome measures were knowledge acquisition and compliance. Fifty-six participants received educational training. Post-educational percentage scores (mean) in those tested increased from 83 (SD 0.1) to 91 (SD 0.1). Before the bCPAP and respiratory guideline implementation, zero of seven infants born at < 30 weeks gestation received bCPAP through 32 weeks gestational age. After education and guideline implementation, 10 of the eligible infants at the end of the project period had bCPAP discontinued at 32 weeks or greater gestational age and were discharged home without requiring any respiratory support. Stakeholder involvement and education before bCPAP and respiratory management guideline change for infants born weighing < 30 weeks gestation may improve knowledge and compliance. Longer term benefits may be measured in future studies.