Implementation of Nasal High Flow: A Remote Context

Grant ID: R&R-027-2018-WEST

Project Summary

In this study, the clinician-researchers are exploring whether nasal high flow (NHF) therapy can be safely and effectively used to improve health outcomes for infants with bronchiolitis in isolated remote communities, in particular for remote Indigenous Australians who have a higher incidence rate of bronchiolitis than non-Indigenous Australians. There is a desire by clinicians to implement NHF in remote areas, but this should undergo similar scientific scrutiny as previous published data.

NHF is a respiratory support system that provides support for people with respiratory conditions and is applied by high flow oxygen through nasal prongs. The therapy can avoid an escalation of care during hospitalisation. The safety of NHF has been widely studied in tertiary areas and regional hospitals, however, there is a lack of evidence to support safe use in remote settings.

In this study, the researchers are employing a two-phased approach: Firstly, an expert working party establishing agreed safe clinical boundaries for the NHF implementation and utilising expert viewpoints for implementation when managing infants with bronchiolitis. Secondly, a comparison of the outcomes before and after implementation to observe a reduction in escalation of care leading to reduced transfers. A community engagement process, with the focus to keep community members in their country/home environment, will be established to measure psychological, social-emotional and economic benefits of NHF.

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Dissemination

Publication:

- West, S., Franklin, D., Harvey, N. and Cairns, A., 2024. Nasal high flow therapy in remote hospitals: guideline development using a modified Delphi technique. Rural and Remote Health 2024; 24: 8516. https://doi.org/10.22605/RRH8516

Presentations:

- West, S., Implementation of a nasal high flow guideline and the impact on retrieval rates from Thursday Island, Cooktown, and Weipa, Australia. RACGP WONCA 2023 Conference, Sydney, Australia, 26-29 October 2023.

- West, S. and Rodert, S., Implementation of nasal high flow therapy in the remote communities of Thursday Island, Weipa, and Cooktown (poster). CRANAplus Conference, Cairns, Australia, 11-12 October 2023.

- West, S., Aus Institute Trop Health and Medicine, COHORT Presentation 10th Conference. Nasal high flow implementation study in the remote context. 7th Sept 2021.

- West, S., Remote Nasal High Flow Therapy Guideline Development. North West Outback Allied Health Forum, 24 & 25th June 2021.

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