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

Gloria Johnson1, Sushma Nuthakki, Kaashif Ahmad

  • 1Author Affiliations: Pediatrix Medical Group, Neonatology of Houston, Houston, Texas (Mrs Johnson, and Drs Nuthakki, Ahmad, Roitsch, Maruna, and Horst); Department of Neonatology, The Woman's Hospital of Texas, Houston, Texas (Mrs Johnson, and Drs Nuthakki, Ahmad, Roitsch, Maruna, and Horst); and Texas Tech University Health Sciences Center, School of Nursing, Lubbock, Texas (Toon).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|February 2, 2026
PubMed

Insights

Implementing FlexiTrunk CPAP in the NICU improved nursing confidence and compliance. However, this study did not show a reduction in bronchopulmonary dysplasia (BPD) rates despite enhanced education on continuous positive airway pressure (CPAP) delivery.

Area of Science:

  • Neonatal intensive care
  • Respiratory support
  • Quality improvement initiatives

Background:

  • Increasing rates of bronchopulmonary dysplasia (BPD) necessitate investigation into preventative strategies.
  • Continuous positive airway pressure (CPAP) delivery methods may influence BPD risk.
  • A local NICU observed a rise in BPD, prompting a review of care practices.

Purpose of the Study:

  • To decrease BPD rates by 20% following the adoption of FlexiTrunk CPAP.
  • To enhance nursing confidence and compliance with FlexiTrunk CPAP through targeted education.

Main Methods:

  • A level IV NICU with 242 infants using CPAP was studied.
  • Staff received education on FlexiTrunk CPAP via representatives, symposiums, and algorithms.
  • Nursing confidence, device compliance, and BPD rates were measured pre- and post-intervention.

Main Results:

  • FlexiTrunk CPAP implementation led to over 93% compliance.
  • Nurse confidence significantly improved post-intervention.
  • Bronchopulmonary dysplasia rates did not change during the study period.

Conclusions:

  • Effective staff education is vital for successful FlexiTrunk CPAP implementation.
  • Diverse educational approaches support quality improvement in neonatal care.
  • Further research is needed to assess long-term BPD prevention strategies and outcomes.
Abstract

Keywords:
Plan, Do, Study, Act (PDSA)bronchopulmonary dysplasia (BPD)continuous positive airway pressure (CPAP)length of hospital stayneonatal intensive care unitquality improvement

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