Experiences of a Regional Quality Improvement Collaborative to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit
Abstract
:1. Introduction
2. Materials and Methods
2.1. Collaborative Creation and Context
2.2. Ethical Approval
2.3. Operational Definitions
2.4. Outcome Measures
2.5. Data Collection and Reporting
2.6. Benchmarking Goals
2.7. Regional Collaboration and Interventions
3. Results
3.1. Primary Outcome
3.2. Secondary Outcomes and Additional Observations
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Intervention | Center A | Center B | Center C | Center D |
---|---|---|---|---|
Establishment of UE QI team | ++ | + | ++ | ++ |
Adoption of UE operational definition | ++ | ++ | ++ | ++ |
Standardized UE subtypes | ++ | ++ | ++ | ++ |
Apparent cause analysis of UE events | ++ | ++ | ||
NICU-wide multidisciplinary education sessions on UE | ++ | + | ++ | ++ |
Feedback and UE data sharing with staff | ++ | + | ++ | + |
Bedside cards as visual reminders | ++ | ++ | ++ | ++ |
Standardized “ABCD” approach to assess infants with desaturation/bradycardia to prevent unnecessary rETT | ++ | +, ++ | ++ | ++ |
Adoption of new ETT securement methods (commercial device, brand of tape, and taping strategy) | ++ | +, ++ | ++ | ++ |
Potential UE scenario simulations for staff education | + | + | ||
Changes in staffing protocols for ETT adjustment and moving patients | ++ | ++ | ++ | + |
Family education on UE prevention * | ||||
Creation of “airway task force” to assess ETT position and securement | ++ | ++ | + | |
Extension of UE monitoring to NICU patients located outside of NICU (delivery room, operating room, and transport) | + |
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Nelson, M.U.; Pinheiro, J.M.B.; Afzal, B.; Meyers, J.M. Experiences of a Regional Quality Improvement Collaborative to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit. Children 2022, 9, 1180. https://doi.org/10.3390/children9081180
Nelson MU, Pinheiro JMB, Afzal B, Meyers JM. Experiences of a Regional Quality Improvement Collaborative to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit. Children. 2022; 9(8):1180. https://doi.org/10.3390/children9081180
Chicago/Turabian StyleNelson, Melissa U., Joaquim M. B. Pinheiro, Bushra Afzal, and Jeffrey M. Meyers. 2022. "Experiences of a Regional Quality Improvement Collaborative to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit" Children 9, no. 8: 1180. https://doi.org/10.3390/children9081180