Neonatal Unit, St George's Hospital NHS Foundation Trust, London, United Kingdom (Dr Shetty, Dr Evans, and Dr Kulkarni); St George's University of London, London, United Kingdom (Drs Shetty and Kulkarni); Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine (Professor Greenough), and Asthma UK Centre for Allergic Mechanisms in Asthma (Dr Greenough), King's College London, United Kingdom; and NIHR Biomedical Research Centre based at Guy's and St Thomas NHS Foundation Trusts and King's College London, United Kingdom (Professor Greenough).
Adv Neonatal Care. 2022 Feb 1;22(1):22-27. doi: 10.1097/ANC.0000000000000856.
Neonates often receive noninvasive respiratory support via continuous positive airway pressure (CPAP) or high-flow nasal cannula oxygen (HHFNC). The decision to change from one mode to the other, however, is not evidence based, hence not standardized and does not consider cost implications.
To assess the introduction of a care bundle for the medical and nursing staff in a tertiary medical and surgical neonatal center with regard to any financial savings or adverse outcomes.
An education package and written guidelines were used to increase the awareness of the durations for which CPAP and HHFNC Vapotherm (VT) circuits could be used and the costs of the circuits.
This resulted in a cost saving of £17,000 ($22,254) for the year without adverse outcomes.
Introduction of a care bundle involving an education package and written guidelines to increase the awareness of the durations that circuits could be used and the costs of CPAP and HHFNC circuits among the medical and nursing staff can lead to cost savings when incorporated into clinical practice.
Strategies, particularly during weaning, which involve changing from one form of noninvasive respiratory support to another, need a greater evidence base. Future research should include awareness of the duration different circuits could be used and the cost implications of changes between modes and hence circuits.
新生儿常通过持续气道正压通气（CPAP）或高流量鼻导管吸氧（HHFNC）接受无创呼吸支持。然而，从一种模式切换到另一种模式的决策并非基于证据，因此未标准化，也不考虑成本影响。
评估在一家三级医疗和外科新生儿中心为医护人员引入护理包，以评估其在任何财务节省或不良结果方面的效果。
使用教育包和书面指南来提高医护人员对 CPAP 和 HHFNC Vapotherm（VT）回路使用时间和回路成本的认识。
这导致当年节省了 17000 英镑（22254 美元），且无不良后果。
引入护理包，包括教育包和书面指南，以提高医护人员对 CPAP 和 HHFNC 回路使用时间和成本的认识，将其纳入临床实践可节省成本。
需要更多的证据来支持策略，特别是在撤机期间，涉及从一种无创呼吸支持形式切换到另一种形式。未来的研究应包括对不同回路使用时间的认识，以及模式和回路之间变化的成本影响。
