Graduation Semester and Year
Summer 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Sharon Blackerby
Abstract
Background
Respiratory Distress Syndrome (RDS) is a leading cause of morbidity and mortality in premature infants. It is managed with continuous positive airway pressure (CPAP), but CPAP can mask the signs of RDS, and delay surfactant therapy.
Purpose
This quality improvement project (QI) was to assess healthcare providers’ confidence in RDS and surfactant therapy through pre- and post- surveys and provided education on RDS and the implementation of the Simplified Downes Scoring Tool to assess respiratory distress in premature infants (25-36 weeks gestation).
Methods
In a Level III NICU, healthcare providers received education on RDS and the scoring Tool, they completed pre- and post-intervention confidence surveys. Eligible infants were scored with the Simplified Downes Scoring Tool. Survey scores were analyzed using descriptive statistics and a one-tail paired-samples test.
Results
Eleven healthcare providers completed the pre- and post-surveys (n=11). On the confidence scale, lower scores indicated greater confidence. The mean score decreased from 22.27 (SD=4.29), to 19.18 (SD=5.83), a statistically significant improvement, t(10) = 2.181, p = 0.027, d = 0.658. The Simplified Downes Scoring Tool showed that of those infants scored (n=12), the mean gestational age was 32 4/7 weeks, a median of 32 4/7 weeks, and a mode of 34 6/7 weeks
Implication for Practice and Research
The Simplified Downes Scoring Tool supported a standardized, objective approach to assessing infants with RDS, and the pre- post survey showed an increased confidence of the healthcare providers. Implementation with a larger sample is needed to evaluate its effect on surfactant therapy and timing.
Keywords
premature, the Simplified Downes Scoring Tool, respiratory distress syndrome, surfactant
Disciplines
Maternal, Child Health and Neonatal Nursing
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Oney, Jennifer, "Implementation of the Downes Scoring Tool" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 20.
https://mavmatrix.uta.edu/nursing_dnpprojects2/20