Helping Neonatal Teams Assess Their Preparedness for Less Invasive Surfactant Administration
Less Invasive Surfactant Administration, known as LISA, is becoming an increasingly important technique in supporting preterm infants with respiratory distress syndrome. It allows babies to stay on CPAP and breathe spontaneously while receiving surfactant through a thin catheter, avoiding the need for intubation and mechanical ventilation.
To help neonatal teams understand how prepared they are to deliver LISA safely and confidently, we have created a simple, practical readiness checklist. It takes only a few minutes to complete and provides a clear overview of your strengths, any gaps, and opportunities for improvement.
What is LISA?
LISA is a technique used to give surfactant to spontaneously breathing preterm infants on CPAP. By avoiding intubation, LISA reduces airway trauma and ventilation related injury. It also supports more stable physiological transitions and can lower the risk of bronchopulmonary dysplasia. In short, LISA helps provide gentler, more protective respiratory care for vulnerable infants.
Why LISA Matters
LISA offers a gentler, more physiologically supportive approach to surfactant delivery for preterm infants with respiratory distress syndrome. By allowing babies to remain spontaneously breathing on CPAP, LISA reduces the need for intubation and mechanical ventilation, which are associated with airway trauma, instability, and longer‑term complications. Evidence shows that using LISA can help lower rates of bronchopulmonary dysplasia, minimise ventilation‑associated injury, and support more stable respiratory transitions. When implemented well, LISA can improve short‑ and long‑term outcomes while enabling a smoother, less invasive experience for infants and their families. Ensuring your unit is ready means your team has the right skills, pathways, and resources to deliver this technique safely, consistently, and confidently.
Who Is This Checklist For?
This readiness checklist is for any neonatal service involved in respiratory care for preterm infants. It supports nurses, ANNPs, medical staff, educators, and governance or quality improvement leads. Whether your unit is new to LISA or looking to strengthen existing practice, the checklist provides a useful starting point for reflection and planning.
What Will You Get Out of It?
By completing the checklist, you will gain a clear picture of your unit’s current readiness across skills, equipment, workflow, communication, and governance. Your responses will highlight areas where you are already strong and areas where further preparation may be helpful. These insights can support planning, training, and quality improvement so your team can embed LISA safely and consistently.
How the Scoring Works
Your score reflects how prepared your team is across seven key areas. Higher scores indicate strong readiness for LISA. Lower scores help identify where foundational work is needed before implementation. There are no right or wrong answers. The scoring is designed to guide improvement and support the safe introduction of LISA into everyday practice.
The LISA Readiness Checklist
1. Clinical Criteria and Pathway Readiness
This section looks at how clear and consistent your team is in identifying suitable infants for LISA. Well defined clinical criteria and an agreed pathway create confidence and reduce variation in practice.
2. Skills and Training
The success of LISA relies on a well-trained and competent team. This part will explore the confidence, experience, and ongoing educational support available within your unit.
3. Equipment Availability
Having the right equipment, organised and ready to use, is essential for a smooth procedure. This section will assess whether your unit is prepared from an equipment and resource perspective.
4. Procedure Workflow
Clear roles, agreed steps, and consistent documentation help ensure safe and efficient delivery. This section will review how well your team has planned and standardised its LISA workflow.
5. Comfort and Stabilisation
Supporting infants to remain comfortable and physiologically stable is critical during LISA. This section considers how well your team applies comfort and breathing support strategies.
6. Family Communication
Families need clear, supportive information at every step. This section reflects on how confidently staff communicate with parents before and after the procedure.
7. Governance, Audit and Quality Improvement
Embedding LISA requires strong governance and continuous learning. This section explores your unit’s approach to auditing outcomes, refining guidelines, and feeding learning back into practice.
Take the Assessment
Once you complete the checklist, you will receive your score along with a tailored implementation guide. This will outline practical steps to support your team as you work towards safe and confident LISA delivery.
If you would like your results emailed to you, simply provide your contact details at the end of the quiz. Our team can also talk you through your outcomes and help you explore how to implement LISA in your unit.
Conclusion
The LISA Readiness Checklist is designed to give neonatal teams a clear, practical understanding of how prepared they are to deliver Less Invasive Surfactant Administration safely and confidently. By reflecting on your current skills, pathways, equipment, and team communication, you can identify the steps that will support smoother implementation and better outcomes for infants and families.
Whether your unit is just beginning its LISA journey or strengthening established practice, this tool will help guide your next steps. We encourage you to complete the assessment, explore your results, and use the tailored implementation guidance to support continuous improvement across your service.
If you would like support interpreting your results or planning your next actions, our team is here to help.
