NeoLISA - A New Method of Less Invasive Surfactant Administration Developed based on in Situ Simulation

Background: Respiratory distress syndrome (RDS) caused by surfactant deficiency is the major cause of respiratory distress in preterm neonates. Exogenous surfactant therapy is effective in reducing RDS-related mortality and morbidity. Due to the complications of surfactant administration, minimal or less invasive administration techniques have been developed and appear promising. Objective: To address the knowledge gaps in less invasive surfactant administration techniques at the level of the health care worker (HCW). Methodology: Four simulation-training sessions were conducted in April 2020, two before and two after the NeoLISA technique was developed. The neonatal clinical team consisted of neonatology specialists and neonatal nurses. Results: Each simulation session lasted for approximately 30 minutes, including debriefing. The learnings during this process were discussed, and the new technique of NeoLISA was developed. The key change was the development of method to confirm the catheter position so as to minimize the surfactant wastage. Conclusion: A new method for surfactant administration was developed. An innovative bedside clinical method confirming catheter position into the trachea has been developed.