A quality improvement initiative to reduce excess inhaled therapy use in the neonatal intensive care unit.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2024-10-03 DOI:10.1038/s41372-024-02132-w

Avery Zierk, Mary Jo Gumbel, Rachel Mackenzie, Kelle Matthews, Francis Simmons, Anna Bustin, Christina DeFelice, Heidi Morris, Leane Soorikian, Kimberly Swartz, Amanda Nickel, Kathleen Gibbs

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引用次数: 0

Abstract

Objective: Inhaled medications are commonly used at our single-center, Level IV neonatal intensive care unit (NICU). We lacked a standardized process for measuring efficacy of these medications to guide optimal duration of use, potentially leading to their overuse.

Methods: We utilized quality improvement methodology to reduce the length of inhaled hypertonic saline (HTS) course durations and high frequency albuterol use. Interventions included education, data sharing, and implementation of a respiratory therapy assessment tool.

Results: The average inhaled HTS course duration decreased from 8.7 to 4.2 days. The percentage of q4 albuterol administrations per total albuterol doses administered monthly decreased from 39 to 20%.

Conclusion: Developing a shared mental model between interprofessional providers for the indication and effect of inhaled agents and standardizing assessment of these medications' efficacy can reduce their overuse.

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一项旨在减少新生儿重症监护室过量使用吸入疗法的质量改进计划。

目的：新生儿重症监护病房（NICU）是一家单中心四级新生儿重症监护病房，常用吸入药物。我们缺乏衡量这些药物疗效的标准化流程来指导最佳用药时间，这可能会导致药物的过度使用：我们利用质量改进方法缩短了吸入性高渗盐水（HTS）疗程和高频率使用阿布特罗的时间。干预措施包括教育、数据共享和实施呼吸治疗评估工具：结果：吸入高渗盐水的平均疗程从 8.7 天缩短至 4.2 天。结果：吸入式 HTS 的平均疗程从 8.7 天减少到 4.2 天，q4 阿布特罗用药量占每月阿布特罗总用药量的比例从 39% 减少到 20%：结论：在跨专业医疗服务提供者之间就吸入式药物的适应症和效果建立共同的心理模型，并对这些药物的疗效进行标准化评估，可以减少药物的过度使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.