An interdisciplinary initiative to reduce unplanned extubations in pediatric critical care units

Pediatrics
Jon KaufmanEmily Dobyns

Abstract

Unplanned extubations in pediatric critical care units can result in increased mortality, morbidity, and length of stay. We sought to reduce the incidence of these events by reliably measuring occurrences and instituting a series of coordinated interdisciplinary interventions. This was an internal review board-approved quality improvement project. Data were prospectively collected from the electronic medical record, and analyzed over 24 months (January 1, 2009-December 2010), and divided into 3 periods: baseline (9 months), intervention with multiple rapid improvement cycles (8 months), and postintervention (7 months). Interventions included standardization of endotracheal tube taping practices upon admission, improved patient handoffs, systematic review of unplanned events, reexamination of sedation practices, and promotion of transparency of performance measures. The PICU experienced 21 events in the 9 months before the initiative, 13 events over the 8-month intervention period, and 5 events in the 7-month postintervention period. The cardiac intensive care unit (CICU) experienced 11, 4, and 0 events, respectively. Mean event rates per 100 patient days for each interval were 0.80, 0.50, and 0.29 for the PICU and 0.74, 0.44, a...Continue Reading

Citations

Sep 30, 2014·Early Human Development·Peter LachmanManveer Rahi
Apr 23, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Dantin J RoddyDarren Klugman
May 26, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Atul VatsPinar Keskinocak
Nov 7, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Nina M CensoplanoJon Kaufman
Apr 7, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Moonjoo Han, James P Marcin
Feb 13, 2021·Pediatric Quality & Safety·Maheshwar MahasethGirija Natarajan
Jul 22, 2021·Archives of Disease in Childhood·Paulo Sergio Lucas da SilvaMarcelo Cunio Machado Fonseca

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