Improved Less Invasive Surfactant Administration Success in Preterm Infants after Procedure Standardization

• Published in: Children (Basel) Vol. 8; no. 12; p. 1145
• Main Authors: Liebers, Björn, Ebenebe, Chinedu Ulrich, Wolf, Monika, Blohm, Martin Ernst, Vettorazzi, Eik, Singer, Dominique, Deindl, Philipp
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06.12.2021; MDPI
• Subjects: Abortion; Babies; Birth weight; Catheters; Educational films; Gestational age; Intervention; Intubation; less invasive surfactant administration; neonate; Newborn babies; Patients; Pediatrics; Premature babies; Process controls; Quality control; Quality improvement; Respiratory distress syndrome; Standardization; Success; Surfactants; Ventilators; Austria; Germany; respiratory distress syndrome; neonate; less invasive surfactant administration; quality improvement
• ISSN: 2227-9067; 2227-9067
• DOI: 10.3390/children8121145

Less invasive surfactant administration (LISA) has been introduced at our tertiary Level IV perinatal center since 2016 with an unsatisfactory success rate, which we attributed to an inconsistent, non-standardized approach and ambiguous patient inclusion criteria. This study aimed to improve the LISA success rate to at least 75% within 12 months by implementing a highly standardized LISA approach combined with team training. The Plan Do Study Act method of quality improvement was used for this initiative. Baseline assessment included a review of patient medical records 12 months before the intervention regarding patient characteristics, method success rate, respiratory, and adverse outcomes. A multi-professional team developed a standardized LISA approach and a training program including an educational film, checklists, pocket cards, and team briefings. Twenty-one preterm infants received LISA before and 24 after the intervention. The mean LISA success rate improved from 62% before the intervention to 92% ( = 0.029) after the intervention. Implementing a highly standardized LISA approach and multi-professional team training significantly improved the methods' success rate.