Effectiveness of Bubble Continous Airway Pressure On: Infant Respiratory Distress at Embu Level 5 Referral Hospital
Effectiveness of Bubble Continous Airway Pressure On: Infant Respiratory Distress at Embu Level 5 Referral Hospital
Effectiveness of Bubble Continous Airway Pressure On: Infant Respiratory Distress at Embu Level 5 Referral Hospital
PRESENTED
BY
KARIUKI RONALD
D/MET/19001/030
JUNE 2021
BACKGROUND OF THE STUDY
• The use of mechanical ventilation and oxygen supplementation are the
two major attributes to CLD (Chronic lung diseases).
• Continuous positive airway pressure (CPAP) has recently become the
primary mode of respiratory support in premature infants.
• CPAP is a gentle and effective tool to treat preterm and low birth
weight infants in respiratory distress.
• In bubble CPAP (b-CPAP), pressure is safely regulated by submerging
the end of the tubing in a bottle of water. The depth of water
determines the pressure in the system.
• This pressure helps recruit alveoli and increase functional residual
lung capacity, thus lowering the baby’s work of breathing.
• The result is; better compliance, reduced airway resistance,
conservation of surfactant, and stabilized chest and diaphragm.
• Prematurity and respiratory disease are leading causes of neonatal
death in Kenya. CPAP is a simple and relatively low-cost lifesaving
intervention.
• It is important that the appropriate training, equipment maintenance
and education of staff is carried out so that CPAP can remain
successful, sustainable and definitely effective.
LITERATURE REVIEW
1. Maintenance strategies of the b-cpap
A qualified individual such as clinical or biomedical engineer or other qualified
person must monitor, test, calibrate and maintain the equipment periodically in
accordance with manufacturer’s recommendations.
The care and maintenance of CPAP equipment is relatively easy. It’s a simple matter
of keeping everything clean.
Every morning
Clean your CPAP mask cushion and humidifier water tub. Over time the skin
releases oils that can reduce the quality and performance of your seal and mask.
This is done by gently rubbing with warm water and mild soap.
Every month
Check the mask cushion and humidifier water tub for wear, tear and deterioration. If
any component has cracked or become cloudy or pitted, it should be replaced.
Every two years
The b-cpap should be taken back to the accredited outlet to have it
pressure tested to ensure the patient is still receiving the correct
pressure.
Every three months
Examine the air tubing for small holes or tears, especially around the
cuff, that could cause air leaks and potentially any tears. Incase of any
replacement should be done
Every six months
The filter at the back of your sleep apnea machine should be checked.
Some can be rinsed but others must be replaced. A build-up of dust can
impede the effectiveness of your treatment.
Inspect the humidifier water tub for wear and deterioration. Clean any
white powder deposits using a solution of vinegar and water.
2. Hospital equipment management of b-cpap
The challenges involved in hospital equipment management reported at
Embu County referral are:
i. Absence or little budgetary support for maintenance.
ii. The lack of the framework for regular auditing system.
iii. Lack of knowledge and innovative ways of using the new models of
the equipment.
iv. Delayed fault reporting, example patching up leaking tubes with
plaster
v. The difficulty in obtaining spare parts such as the filters.
vi. Failure to provide technical training to operators.
3. Skill and knowledge of the user.
To ensure the equipment is used in a safe and correct manner is vital,.
The teaching programme and dissemination of the guideline improves
pediatric healthcare workers ability to setup and appropriately use
CPAP.
After teaching sessions health workers involved with the use, repair and
maintenance feel more confident on how to set up the equipment and
how to care for an infant while on the CPAP
PROBLEM STATEMENT
Although b-CPAP has been widely recommended for managing
respiratory distress, it remains largely inaccessible in resource-limited
settings. This happens despite it being of low-cost and also it being an
effective way to improve the respiratory status of preterm and (VLBW)
infants.
It has however been utilized in (HICs) for decades where it has been
noted that infant mortality due to respiratory problems such as RDS has
been greatly reduced.
At Embu County referral hospital, ineffectiveness of b-CPAP is due to
lack of training of health care providers, poor handling and lack of
qualified technicians for regular maintenance and repair services. This
incorporates safe assembly, maintenance and trouble-shooting of issues
related to b-CPAP.
OBJECTIVES
Broad objectives
To determine the effectiveness of bubble continuous airway pressure on
infant respiratory distress at Embu level 5 referral hospital
Specific objectives
1. To investigate the technical skills of the bio-meds in repair and
maintenance of b-cpap.
2. Assess the skill and knowledge of the user on the b-cpap machine.
3. To determine how hospital equipment management policies
contribute to effectiveness of the b-cpap machine.
RESEARCH QUESTIONS
1. Are the technicians skilled in repair and maintenance of the b-cpap?
2. Does the user have the skill and knowledge of operating the b-cpap?
3. How does the hospital management policies contribute to the
effectiveness of the b-cpap?
STUDY METHODOLOGY
STUDY DESIGN
In this study a descriptive research design was adopted since the study
aims at determining the effectiveness of b-cpap on infant respiratory
distress. It makes it easier to identify and obtain information on the said
issue.
STUDY AREA
This study was carried out at Embu County Referral which is located at
the outskirts of Embu town on Embu-Meru highway. It is the main
hospital for Eastern Province providing both inpatient and outpatient
services for a large population
STUDY VARIABLES
Dependent variable
This is the variable that the researcher is mainly interested in carrying
out the study. In our case this are the factors that contribute to the
effectiveness of the b-cpap
Independent variable
These are variable that support the study of the research which include
Training programs
Maintenance schedule
STUDY POPULATION
This study will mainly target the following people in Embu County
Referral
Biomedical engineer’s technologist who are (11)
Equipment users/Clinicians (10 people)
Inclusion criteria
The study will involve all the bio-medical engineers involved with
repair and maintenance of the b-cpap. It will also involve the clinicians
involved in operating the b-cpap machine while attending to the patient.
Exclusion criteria
• This research will exclude all the engineers and the operators who will
be on leave at the time or sick off.
SAMPLE TECHNIQUE
Stratified random sampling technique will be used first since ensures
members in both groups are represented properly in the sample, it will
later use the simple random sampling.
DEVELOPMENT OF DATA COLLECTION TOOL
The data of this study will be collected through questioners, interviews
and observation. The tools to be used will be questioner papers and a
pen.
DATA COLLECTION PROCESS
This research will include all biomedical engineers and clinicians
involved in the operation of the b-cpap machine
DATA ANALYSIS
After collecting the data, the research will analysis the data by use of
tables and then will be presented using bar graphs.
APPENDICES
(I) Budget
Items Quantity Unit cost Total
Printing 60 10 600
Pens 3 25 75
questioner
Total 2,975
(II) Work Plan
Topic cover
Concept paper
Proposal writing
Presentation
Data collection
REFERENCES
• Aly, H., 2020. CLINICAL RESEARCH ARTICLE. Pediatric Research.
• Boatemaa, M. A., 2017. Hospital Equipment and its Management System. issue 2
ed. Ghana: Juniper.
• David, Y., 2003. Yadin David. 1st Edition ed. UK : CRC Press.
• Nahimana et al., 2015. Bubble CPAP to support preterm infants in Rwanda. BMC
Pediatrics.
• Peters, B., 2020. CPAP Cleaning Tips: A Step-By-Step Maintenance Guide. Very
Well Health.
• Pinto, V. L., 2021. Continuous Positive Airway Pressure. StatPearls.
• Stoeri, A. L., 2009. Correlational Study for Predictor Variables Affecting Duration
on Bubble CPAP, Georgia: Georgia State University.