Breathe Easier: Optimizing Continuous Positive Airway Pressure in the Neonatal Intensive Care Unit

Background: Rates of bronchopulmonary dysplasia (BPD) continue to increase despite advances in healthcare. Various methods of delivering continuous positive airway pressure (CPAP) can be contributing factors that increase the risk of developing BPD. A recent increase in BPD rates at a local neonatal intensive care unit (NICU) prompted further investigation into potential preventative practices. Purpose: The project’s goal was to reduce rates of BPD in the NICU by 20% after transitioning to FlexiTrunk CPAP, as well as through education to increase nursing confidence, which will improve compliance with FlexiTrunk CPAP usage. Methods: A level IV NICU was targeted, including 242 infants on whom CPAP was being utilized. Interventions during the implementation of FlexiTrunk CPAP included staff education from the new device’s representatives, posters displayed during a skills symposium, PowerPoint slides, and real-time education using algorithms. Nursing confidence levels, compliance rates on device usage, and BPD rates were assessed before and after the implementation of FlexiTrunk CPAP. Results: After implementing FlexiTrunk CPAP, compliance with device usage in the level IV NICU improved to over 93% as nurse confidence improved. However, BPD rates remained the same during the study period in 2024. Implications for Practice and Research: Education and enhanced understanding regarding transition to FlexiTrunk CPAP are crucial to its successful implementation and maintenance. Increasing and providing various methods of educating staff is also key to successful quality improvement initiatives. Further time and research are necessary to evaluate preventative strategies and outcomes for infants with BPD who are in or discharged from the NICU.