Topic: Quality Assurance & Improvement
The effect of standardized endotracheal intubation guidelines
Chung, Yeon Hwa1; Son, Jeong Suk2; Lee, Soon-Haeng3; Huh, Jin Won4; Hong, Sang-Bum4
1Unit Manager, Cardiovascular Care Unit, Asan Medical Center, Seoul, South Korea; 2Nurse, Medical Emergency Team, Asan Medical Center, Seoul, South Korea; 3Team Manager, Department of Intensive Care Nursing, Asan Medical Center, Seoul, South Korea; 4Professor, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, South Korea
Abstract:
INTRODUCTION.
CICO(can´t intubation, can´t oxygenation) situation is directly related to the patient´s life in endotracheal intubation. Delays and failures due to insufficient action results in serious adverse events. So it is very important to prevent serious adverse events in endotracheal intubation and necessary to standardize practice of endotracheal intubation in intensive care unit.
OBJECTIVES.
This study was done to confirm the effectiveness by developing trained nurses in endotracheal intubation and standardized endotracheal intubation guidelines.
METHODS.
It was retrospective observation study comparing pre-intervention with post-intervention and was conducted in a 16-bed adult Cardiovascular Intensive Care Unit. Data was collected pre-intervention (April, 2014 - September, 2014) and post-intervention (April, 2015 - September, 2015). To improve practice of endotracheal intubation, we developed and applied standardized endotracheal intubation guidelines. The standardized endotracheal intubation guidelines were consisted of practice checklist in endotracheal intubation, roles of nurse, feedback to nurses after endotracheal intubation. We educated standardized endotracheal intubation guidelines to nurses and enforced endotracheal intubation under the supervision of MET(Medical Emergency Team) fellows who are proficient in endotracheal intubation. We analyzed the intubation duration time, incidence of hypotension and cardiac arrest after endotracheal intubation, implementation rate of practice checklist in endotracheal intubation.
RESULTS.
Of 72 cases, there were 39 pre-intervention cases and 33 post-intervention cases. Intubation duration time was significantly decreased(pre 9.2±8.4min vs. post 4.6±2.6min, p=.003). Incidence of hypotension after endotracheal intubation was significantly decreased(pre 35.8% vs. post 15.2%, p=.028), and no cardiac arrest occurred during pre-intervention and post-intervention. Implementation rate of practice checklist was maintained above 90% in endotracheal intubation.
CONCLUSIONS.
Intubation duration time and incidence of hypotension after endotracheal intubation was significantly decreased by developing trained nurses in endotracheal intubation and standardized endotracheal intubation guidelines.
References:
No references
Topic: Quality Assurance & Improvement
The effect of standardized endotracheal intubation guidelines
Chung, Yeon Hwa1; Son, Jeong Suk2; Lee, Soon-Haeng3; Huh, Jin Won4; Hong, Sang-Bum4
1Unit Manager, Cardiovascular Care Unit, Asan Medical Center, Seoul, South Korea; 2Nurse, Medical Emergency Team, Asan Medical Center, Seoul, South Korea; 3Team Manager, Department of Intensive Care Nursing, Asan Medical Center, Seoul, South Korea; 4Professor, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, South Korea
Abstract:
INTRODUCTION.
CICO(can´t intubation, can´t oxygenation) situation is directly related to the patient´s life in endotracheal intubation. Delays and failures due to insufficient action results in serious adverse events. So it is very important to prevent serious adverse events in endotracheal intubation and necessary to standardize practice of endotracheal intubation in intensive care unit.
OBJECTIVES.
This study was done to confirm the effectiveness by developing trained nurses in endotracheal intubation and standardized endotracheal intubation guidelines.
METHODS.
It was retrospective observation study comparing pre-intervention with post-intervention and was conducted in a 16-bed adult Cardiovascular Intensive Care Unit. Data was collected pre-intervention (April, 2014 - September, 2014) and post-intervention (April, 2015 - September, 2015). To improve practice of endotracheal intubation, we developed and applied standardized endotracheal intubation guidelines. The standardized endotracheal intubation guidelines were consisted of practice checklist in endotracheal intubation, roles of nurse, feedback to nurses after endotracheal intubation. We educated standardized endotracheal intubation guidelines to nurses and enforced endotracheal intubation under the supervision of MET(Medical Emergency Team) fellows who are proficient in endotracheal intubation. We analyzed the intubation duration time, incidence of hypotension and cardiac arrest after endotracheal intubation, implementation rate of practice checklist in endotracheal intubation.
RESULTS.
Of 72 cases, there were 39 pre-intervention cases and 33 post-intervention cases. Intubation duration time was significantly decreased(pre 9.2±8.4min vs. post 4.6±2.6min, p=.003). Incidence of hypotension after endotracheal intubation was significantly decreased(pre 35.8% vs. post 15.2%, p=.028), and no cardiac arrest occurred during pre-intervention and post-intervention. Implementation rate of practice checklist was maintained above 90% in endotracheal intubation.
CONCLUSIONS.
Intubation duration time and incidence of hypotension after endotracheal intubation was significantly decreased by developing trained nurses in endotracheal intubation and standardized endotracheal intubation guidelines.
References:
No references