Evidence map›Paper›PMID 40336423›Full record

ArticleAfrican journal of primary health care & family medicine2025

Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative.

Hawa D Mahmoud, Sarah C Kent, Fatima E Ibrahim, Najma Mohamed, Fatima A Abdulahi, Meagan N O'Neal, Priya Kanajam, Ellen K Diego

Abstract read
In one paragraph

Article in African journal of primary health care & family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hawa D MahmoudDepartment of Family Medicine, College of Health Sciences, Amoud University, Borama. hawa.dahir@amoud.edu.
Sarah C Kent
Fatima E Ibrahim
Najma Mohamed
Fatima A Abdulahi
Meagan N O'Neal
Priya Kanajam
Ellen K Diego

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundContinuous positive airway pressure (CPAP) therapy is the standard of care for neonatal respiratory distress and improves survival when implemented in low-resource settings. Clinical audits at the Borama Regional Hospital (BRH) Neonatal Intensive Care Unit (NICU) revealed multiple barriers to effective CPAP, including insufficient pressure, a lack of neonatal-sized nasal prongs, and patient interface challenges.

aimImprove respiratory distress by increasing effective CPAP delivery for neonates 30 days of age from 52% to 90% in 6 months.

settingSingle-centre referral hospital in the Awdal region of Somaliland.

methodsQuality improvement (QI) initiative with outcomes displayed using statistical process control (SPC) charts.

resultsEleven residents, three medical interns and seven NICU nurses completed the educational training. Forty-five patients were initiated on the locally designed bubble CPAP (bCPAP) device with a 47% (122/261) CPAP safety checklist completion rate for the three daily nursing shifts. We achieved our study aim by increasing the adherence rate to the 7-item bCPAP device set up from a baseline of 52% to 91%. The rate of infants weaned or discontinued from bCPAP for improved respiratory severity score (RSS) increased from 0% to 18% but did not demonstrate process change. There was no increase in adverse event rates (air leak, nasal columella breakdown and nasal irritation).

conclusionWe demonstrated increased effective bCPAP delivery and decreased respiratory distress.Contribution: This study outlines low-cost, customisable QI strategies to address commonly encountered gaps for effective bCPAP delivery in low-resource settings without access to commercially available CPAP devices or speciality-trained providers.

Indexed as

Continuous Positive Airway PressureQuality ImprovementRespiratory Distress Syndrome, NewbornFemaleHumansInfant, NewbornIntensive Care Units, NeonatalMaleSomaliabubble continuous positive airway pressurelow- and middle-income countriesneonatal intensive care unitneonatal mortalityneonatal respiratory distressquality improvement

Identifiers

PMID40336423
PMCPMC12067503

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.