From InSurE to MIST: A Quality Improvement Initiative in a Level IV NICU
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The authors aimed to increase the utilization of minimally invasive surfactant therapy (MIST) in a Level IV NICU, transitioning from the traditional Intubate-Surfactant-Extubate (InSurE) method, to assess its impact on respiratory care practices and clinical outcomes. Through a structured quality improvement initiative, MIST use rose dramatically from 3% to 97%, leading to a significant decrease in pharmacologic pre-medication use and a notable shift towards noninvasive respiratory management without increasing intubation rates. This study highlights the effectiveness of a multidisciplinary approach in implementing MIST in a high-acuity setting.
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