Knowledge, Attitudes, and Practices of Less Invasive Surfactant Administration Technique Among Workers in the Neonatal Intensive Care Units in Jordan

Abedulrhman Abdelfattah; Hamzeh Al-Momani; Doaa Al-qaoud; Abdallah Hamed Al Mhairat; Amjad Tarawneh; Mohammad Abu Saleh; Majd Allahham; Sarah Al-sheikh; Dana Alhmouz; Abdullah Odeh; Amer Abushawer; Yaseen Abdelqader; Salma Burayzat

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In Press

Received 2025-07-16

Received in revised form

Accepted 2025-10-10

Availabe online 2025-10-26

Pages 0 - 0

Keywords

Jordan
KAP;
NICU;
infants;
surfactant;
RDS;
LISA;
preterm

Abstract

Background: Less invasive surfactant administration (LISA) is a technique of giving surfactants through a thin catheter. It has demonstrated potential in improving the respiratory outcomes in premature babies. The aim was to assess the knowledge, attitudes, practices, and barriers to using the LISA technique among neonatal intensive care unit (NICU) staff in Jordan. Methods: A prospective-observational web-based survey was conducted among 202 NICU staff (general pediatricians, neonatologists, and pediatric residents) from all major health sectors in two Jordanian governorates (Zarqa and Amman). The questionnaire contained 28 demographic, occupational, knowledge, and practice data items. Results: Response rate was 50.5%. Neonatologists were more likely to use LISA (35.1%) than pediatric residents (20.3%) and general pediatricians (43.2%). All LISA users (n = 74, 100%) know the technique, compared to non-users (52.3%) (p < 0.001). The main perceived advantages of LISA were a reduced need for intubation (100% vs. 57.8%) (p < 0.001; OR 57.8, 95% CI 18.9–176.8). And lower risk of airway complications (95.9% vs. 25%) (p < 0.001; OR 57.8, 95% CI 18.9–176.8). The overall knowledge score was significantly higher among LISA users (14.57 ± 3.81) than non-users (10.2 ± 4.95) (p < 0.001; OR 4.37, 95% CI 3.0–5.7). The total score for LISA-specific attitudes and practice was 13.92 ± 3.92. Among non-users, a strong majority (82%) expressed an intention to adopt it in the future. Knowledge score was significantly correlated with practice score (r = 0.320, p = 0.005; 95% CI 0.11–0.52). Conclusions: This study revealed moderate knowledge of LISA among Jordanian NICU staff, while its practice remains limited due to systemic barriers.

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