Summer Student Scholarship
This year the Trust had the pleasure of supporting Emma Wolff a 4th year medical student with her summer research project.
The neonatal intensive care unit (NICU) admits unwell newborn infants at a range of different gestations. Infants born at less than 30 weeks gestation have severely underdeveloped lungs. Many premature infants require respiratory support and oxygen therapy. Oxygen therapy is a delicate balancing act. Too little oxygen is associated with an increased risk of death or brain damage. Too much oxygen is associated with blindness and chronic lung disease.
The level of oxygen in the blood stream is estimated by oxygen saturation monitors. There has been considerable debate regarding optimal target saturation levels for premature infants. The Christchurch neonatal intensive care unit has clear policy guidelines for nursing and medical staff around oxygen saturation targets. A new protocol has recently been introduced in line with national guidelines. However, even when these oxygen saturation targets are set, premature infants can spend up to 50% outside of this target.
This project aimed to:
1. Assess oxygen saturations achieved for the first 72 hours of life in premature infants born <30 weeks gestation and analyse for associations between achieved oxygen saturations and respiratory outcomes
2. Audit alarm settings on oxygen saturation monitors
3. Survey bedside nursing opinion of oxygen saturation targeting and monitoring
4. Formulate recommendations on how the unit may improve oxygen saturation targeting
Due to the small sample size the results need to be interpreted with caution. The audit results have shown that our compliance with protocol is lower than expected but in line with other published studies.
A protocol has been shown to be easier to recall, potentially leading to increased compliance. Further improvements could include further education on the importance of oxygen saturation targeting and a review of time in target and alarm settings during nursing handover and medical ward rounds. In the future once changes have been implemented, an additional audit would be beneficial to illustrate if compliance has improved.