A comparison of the effects of continuous positive airway pressure (CPAP) and headbox oxygen on nurses' workload in the special care nursery

Continuous positive airway pressure (CPAP) is increasingly used in special care nurseries (SCNs) worldwide. Little is known about the workload implications for nurses using CPAP instead of the more traditional headbox therapy in the SCN. The aim of the study was to compare nurses' perceptions of workload intensity when attending to babies receiving either CPAP or headbox oxygen treatments for respiratory distress in non-tertiary SCNs. The relationship between perceived workload attributes was measured. Nurses' preferences for either CPAP or headbox oxygen treatment were ascertained. Nurse workload was measured from August 2004 to June 2006 in five non-tertiary SCNs in two Australian States. All SCNs were using CPAP and headbox oxygen for infants with respiratory distress during a randomised controlled trial comparing these interventions. A total of 281 surveys from 71 nurses were analysed. Eighty-nine surveys were completed when caring for babies receiving headbox oxygen and 192 for babies receiving CPAP. Comparison of treatments on perceived workload intensity showed no significant difference. Higher caseloads negatively affected the amount of time nurses could attend to the trial baby. Commencement of either treatment, time spent with the trial baby, and the use of substitute or casual staff were factors that increased nurses' perceived workload intensity. In conclusion, nurses' preferred CPAP over headbox oxygen. Factors other than CPAP or headbox treatment are associated with nurses' workload when CPAP is already established in the SCN. The use of CPAP in the SCN was well accepted by the nurses.