title: Nursing perceptions of high-flow nasal cannulae treatment for very preterm infants.
abstract: OBJECTIVE
  This study aims to assess nursing perceptions of high-flow nasal cannulae (HFNC) in comparison with nasal continuous positive airway pressure (NCPAP) as post-extubation respiratory support for very preterm infants.
  
  
  METHODS
  A standardised questionnaire form was distributed in person to nursing staff in The Royal Women's Hospital neonatal unit, where HFNC had been recently introduced in the context of a clinical trial. Nursing staff were eligible to participate if they routinely cared for infants receiving respiratory support.
  
  
  RESULTS
  The survey was completed by 99/144 eligible nurses. The majority of the 99 nurses surveyed felt that HFNC was less likely than NCPAP to prevent re-intubation of infants 24-26 weeks' gestation but equally likely to prevent re-intubation of infants 28-30 weeks' gestation. Nurses preferred NCPAP for post-extubation support of 24- and 26-week infants, and HFNC for 28- and 30-week infants, despite being less experienced with HFNC. Perceptions of HFNC compared with NCPAP included increased ease-of-use, improved infant comfort and reduced nasal trauma.
  
  
  CONCLUSIONS
  Neonatal nurses preferred NCPAP for post-extubation support of infants <28 weeks' gestation and HFNC for infants of 28 or 30 weeks' gestation. Nurses accurately predicted varying efficacy of HFNC across different gestational ages, consistent with the findings of a contemporaneous randomised trial. In the context of clinical non-inferiority, as shown in the randomised trial, nursing preference for HFNC over NCPAP in preterm infants ≥28 weeks' gestation supports the use of HFNC as post-extubation support in this population.
authors.affiliation: Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Calum T
authors.initials: CT
authors.lastname: Roberts
authors.forename: Brett J
authors.initials: BJ
authors.lastname: Manley
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dawson
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
mesh_terms: D000328:Adult; D060666:Airway Extubation / Q000379:methods / Q000451:nursing; D001291:Attitude of Health Personnel; D002404:Catheterization / Q000379:methods / Q000451:nursing; D045422:Continuous Positive Airway Pressure / Q000379:methods / Q000451:nursing*; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D017283:Neonatal Nursing / Q000379:methods; D009730:Nursing Assessment; D009741:Nursing Staff, Hospital; D010102:Oxygen Inhalation Therapy / Q000379:methods / Q000451:nursing*; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000628:therapy; D011795:Surveys and Questionnaires
keywords: continuous positive airway pressure; high-flow nasal cannulae; infant; nursing practice; premature; questionnaire