Provider Perceptions of Bubble Continuous Positive Airway Pressure and Barriers to Implementation in a Level III Neonatal Unit in South India
Abstract
Background: Bubble continuous positive airway pressure (bCPAP) is a simple, safe, and cost-effective strategy to provide respiratory support to newborns with respiratory distress syndrome in resource-limited settings. Purpose: To understand whether implementation of bCPAP, relative to other modes of respiratory support in the care of newborns with respiratory distress syndrome, increases positive attitudes about its potential for consistent and widespread use among providers in neonatal intensive care units (NICUs) of lower middle-income countries. Methods: Semistructured qualitative interviews with 14 healthcare providers, including 5 neonatal nurses, 2 respiratory therapists, 5 postgraduate trainees in pediatrics, and 2 attending physicians, were conducted at a level III NICU in south India where bCPAP had been in consistent use for 6 years. Interviews were transcribed and then coded and categorized using NVivo 10 Software (QSR International, Victoria, Australia). Findings: Categories that emerged from our data include (1) perceived indications, (2) learning curve, (3) perceived costs, (4) perceived shortages, and (5) barriers to use. Providers believed that bCPAP was easy to learn and that it helped empower neonatal nurses in decision-making process. Participants provided a nuanced perspective of cost-benefit associated with bCPAP and that it helped make optimal use of limited resources. Participants identified several barriers to the implementation of bCPAP. Implications for Practice: Providers of a level III NICU in a lower- to middle-income country viewed the use of bCPAP favorably. Addressing context-specific barriers will be important for the successful widespread implementation of bCPAP. Implications for Research: Further research will need to focus on whether bCPAP can be safely implemented at level II NICUs. Video Abstract Available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=30&autoPlay=true.
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Limited healthcare infrastructure, including lack of equipment and skilled personnel, may compromise effective use of bubble CPAP in neonatal nurseries.
“Limited healthcare infrastructure, including lack of equipment and skilled personnel, may compromise effective use of bubble CPAP in neonatal nurseries [6,12,13,15].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [15]
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- Authors
- Atreya, M. R., Lorenz, J. M., & Narendran, V.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Corresponding author
- Atreya, Mihir R.
- Venue
- Advances in Neonatal Care
- Published
- 2018-12
- Volume
- 18
- Issue
- 6
- Pages
- 500-506
- ISSN
- 1536-0903 (ISSN-L)
- OpenAlex
- W2805869658
- Cited by
- 12
- References
- 22
- Citations by year
- 2026: 1 · 2025: 2 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 2
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Advances in Neonatal Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- bubble continuous positive airway pressure, neonatal respiratory distress syndrome, provider perceptions, implementation barriers, neonatal intensive care, resource-limited settings, learning curve, cost-benefit analysis, neonatal nurses, respiratory support
- MeSH terms
- Pediatricians, Nurses, Neonatal, Implementation Science, Attitude of Health Personnel, Humans, India, Infant, Newborn, Intensive Care Units, Neonatal, Respiratory Distress Syndrome, Newborn, Respiratory Therapy, Qualitative Research, Continuous Positive Airway Pressure
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