Non-invasive respiratory support and preterm infants: The crucial role of nurse management

Abstract

Premature delivery is often a failure of transition to create an early Functional Residual Capacity (FRC) and therefore preterm infants frequently need a respiratory support. To reduce the occurrence or severity of respiratory distress, neonatologists have to plan an optimal respiratory strategy from the first breath and within the "working-team" the nurses play a crucial role. Since duration of mechanical ventilation via the ET seems related to Bronchopulmonary Dysplasia (BPD), clinicians are increasingly using non invasive respiratory supports (e.g. n-CPAP and Non-Invasive Ventilation-NIV) to try to protect the preterm infant's lungs. Nurses are essential fundamental in choosing the best fitted devices and interfaces (e.g. hat, prongs), in protecting skin from infections, in taking a continuous care of the neonate to avoid nasal trauma, in maintaining and protecting parental bonding. The success of non-invasive respiratory support improves with staff experience and it is recognized that there is an urgent need for continuous education of nursing staff in preventing failure of non-invasive respiratory support.

Improving nursing knowledge and care for neonates with respiratory distress in Jordan

“…Qualified, well‐trained nurses can help preterm neonates recover from RDS and prevent complications (Lista et al. ). This explains the need to assess nurses’ knowledge and the quality of their practice.…”

“…Indeed, specialized medical interventions are recommended to manage RDS in critically ill premature neonates, including surfactant therapy and assisted ventilation (WHO, 2015). It is worth noting that the respiratory care provided for premature neonates by NICU nurses, for example assisting with resuscitation, suctioning, oxygen administration and monitoring oxygen saturation, and thermoregulation, requires specialized knowledge and skills (Lista et al 2013). Inadequate nursing knowledge of the proper care of premature infants on ventilation devices such as NCPAP may place them at greater risk for developing complications.…”

“…Assessing neonates for signs of RDS is crucial when diagnosing and treating this condition. Qualified, well-trained nurses can help preterm neonates recover from RDS and prevent complications (Lista et al 2013). This explains the need to assess nurses' knowledge and the quality of their practice.…”