Satisfaction of Health Professionals Regarding the Short Binasal Prong Used as a Non-Invasive Ventilation Interface in Neonatology

Abstract

Purpose

To evaluate the health professionals’ satisfaction regarding the short binasal prong used in Neonatal Intensive Care Units (NICU), evaluate the difficulties related to its use, and present possible improvements in the design of this device.

Patients and Methods

Observational, cross-sectional study with prospective data collection carried out in the NICU of a public hospital in southern Brazil. This research was presented into two stages. In the first stage, the Quebec User Evaluation of Satisfaction with Assistive Technology was applied with 90 health professionals to evaluate the satisfaction regarding the short binasal prong. In the second stage, the health professional’s experiences and difficulties in using the binasal prongs in 14 newborns (NBs) that required non-invasive ventilation was collected. The short binasal prongs used was the Fanem^® brand and the CPAP circuit was Gabisa Medical International (GMI^®). Finally, improvements and recommendations were presented to optimize the device’s design.

Results

The mean score of the health professionals’ satisfaction with short binasal prongs was 3.8 ± 0.6. Ease of adjustment (3.27) and dimensions (3.62) variables had the worst scores. The main difficulties pointed out by health professionals were: circuit disconnection (57.1%), the size of the prong did not correspond to NBs’ anatomical characteristics (35.7%), air leakage (21.4%), and difficulty in fixing and positioning the prong in the NB (14.28%). The improvements suggested were: appropriate prong sizes based on the anatomical characteristics of the NBs; adjustable distance between insertion and base catheters; manufactured with malleable material, however not easily foldable; curved and adjustable insertion catheters and functional system of tracheas’ connection.

Conclusion

The dissatisfaction of health professionals with the dimensions and prongs adjustments and the difficulties faced in clinical practice indicate the need for improvements in these interfaces. The recommendations presented in this study may contribute to optimizing the design of the binasal prong in the future.

Keywords:

• assistive technology
• neonatal intensive care
• non-invasive ventilation
• surveys and questionnaires

Abbreviations

CPAP, Continuous positive airway pressure; GMI, Gabisa Medical International; HIWM, Hospital Infantil Waldemar Monastier; NB, Newborn; NICU, Neonatal Intensive Care Unit; NIV, Non-invasive ventilation.

Ethics Approval and Informed Consent

This study was performed in accordance with national and international requirements that conduct ethics in research involving human beings, following the Declaration of Helsinki, and approved by the Ethics Committee on Research Involving Human Beings of the Pontifícia Universidade Católica do Paraná - PUCPR under Approval Letter numbers 03198318.5.0000.0020, and 89268418.0.0000.0020. The newborns’ parents were informed about the study and provided written informed consent.

Acknowledgments

We thank Fundação Araucária, Secretaria de Estado da Ciência, Tecnologia e Ensino Superior do Paraná (SETI), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) for scholarships, and Waldemar Monastier Children’s Hospital directly for allowing the study to be performed on the NICU’s premises, Caobianco Materiais Médicos e Hospitalares for the donation of Fanem^® prong.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.