Abstract
Background: Respiratory distress syndrome (RDS) is a common diagnosis for premature infants. Nasal continuous positive airway pressure (NCPAP) is a mode of respiratory therapy frequently used in the treatment of RDS.|Objectives: In March 2012, a new guideline was put into place for NCPAP use in the neonatal population at a large Midwestern hospital. Previously any infant requiring NCPAP would be transferred to the level III Neonatal Intensive Care Unit (NICU). The new guideline allowed infants greater than 30 weeks gestational age and greater than 1250 grams to be supported with NCPAP for up to eight hours in the special care nursery (SCN).|The goals of this research were to determine if respiratory variables for neonates requiring NCPAP admitted to the SCN were acceptable; determine if length of stay was altered; based on the first two goals determine if safe effective care was provided without infant transfer.|Methods: A chart review was completed to determine respiratory outcomes for inborn neonates cared for in the SCN or NICU with birth weight greater than 1250 grams for the last four years. The first two years of data will be baseline data and the last two years will be post intervention data.|Results: The rate of NCPAP at birth, the rate of intubation, and the length of stay were decreased in the post intervention sample. The majority of infants required 8 or less hours of NCPAP. The rate of pneumothoraces did not increase.|Conclusions: Safe and effective care was provided in the SCN decreasing the need for transfer to the level III NICU for many of the infants in the post intervention group.