Improving First-Attempt Intubation Success Rate in a Level IV Neonatal Intensive Care Unit Through the Use of a Video Laryngoscope: A Quality Improvement Initiative.

Abstract

There is increasing evidence that the use of a video laryngoscope improves first-attempt intubation rates in neonates. The goal of this quality improvement initiative was to improve the first-attempt intubation success rate from 45 to 65% in 2.5 years through the introduction and increased use of a video laryngoscope in a level IV neonatal intensive care unit (NICU).We utilized the Model for Improvement with plan-do-study-act cycles targeted at increasing buy-in and comfort with the use of a video laryngoscope. Data on 418 intubations were collected from November 2021 to April 2024.Through increasing routine use of the video laryngoscope, achieved via a staggered introduction of the device, creation of reference materials, and coaching workshops, we improved the overall first-attempt intubation success rate from 45 to 57% during the intervention period.We increased the first-attempt success rate of intubations in the NICU by effectively implementing the use of a video laryngoscope into daily practice. · Neonatal intubations have low success rates, but video laryngoscopy improves success especially for those with less experience.. · This study shows that video laryngoscopy adoption in a neonatal ICU improved first-attempt intubation rates.. · This study contributes to neonatal intubation and video laryngoscopy literature from a quality improvement perspective..