Andrew P. Reimer PhD, RN, CFRN, FAAN , Joshua Driscoll BSN, RN, CCRN , Lisa Lorenz MSN, ACNP, CCRN , Abigail Brown DNP, MBA, APRN, ACNP-C, CCRN, EMT-P , Travis Gullett MD, MATS, FACEP , Fredric M. Hustey MD
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引用次数: 0
Abstract
Objective
Advanced airway management is a primary skill critical care transport teams provide. There are several measures of performance for airway management that can be tracked and improved through quality improvement initiatives. The purpose of this project was to improve first-pass intubation success rates and the associated Definitive Airway Sans Hypoxia/Hypotension on First Attempt (DASH-1A) metric—definitive airway without hypoxia or hypotension.
Methods
A multiyear quality improvement initiative was undertaken. Best practices from the literature were identified and implemented through the Institute for Healthcare Improvement Model for Improvement using a plan-do-study-act cycle approach. Improvement cycles included airway training in a cadaver laboratory, implementation of an airway checklist, use of high-fidelity airway mannequins with simulation, and difficult airway mannequins that could be used for on-shift training. We prioritized tracking of first-pass intubation success rates with focused communication to the team.
Results
There was incremental improvement in first-pass success rates evidenced by the stepwise increase in annual moving averages starting at 59% and progressing to the current annual average at approximately 95%. Similarly, DASH-1A results exhibit similar incremental improvement in the moving annual average year on year, starting at 59% and improving to the current 92% annual average.
Conclusion
Our results demonstrate that a dedicated quality improvement project focused on improving airway management, specifically first-pass success and DASH-1A, improved our transport team's performance over time.
期刊介绍:
Air Medical Journal is the official journal of the five leading air medical transport associations in the United States. AMJ is the premier provider of information for the medical transport industry, addressing the unique concerns of medical transport physicians, nurses, pilots, paramedics, emergency medical technicians, communication specialists, and program administrators. The journal contains practical how-to articles, debates on controversial industry issues, legislative updates, case studies, and peer-reviewed original research articles covering all aspects of the medical transport profession.