Employing a multidisciplinary tracheostomy team to improve the care process of pediatric patients

IF 1.3 4区 医学 Q3 OTORHINOLARYNGOLOGY
Amulya Vankayalapati , Michelle Coleman , Janet N. Germann , Michelle A. Tate , Theresia Tuttle , Lisa Mack , Dan Benscoter , Catherine K. Hart , Matthew M. Smith
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Abstract

Objective

Describe the varied components (staff education, system capability, family education) of a multidisciplinary, inpatient pediatric tracheostomy team.

Methods

After its initiation in January 2019, a multidisciplinary tracheostomy team at a tertiary pediatric medical center developed an improvement plan with multiple interventions, utilizing a mixed methodology of features from Lean in Medicine and the Institute for Healthcare Model for Improvement. Interventions included education modules, the creation of a house-wide collaborative, adjustments to the electronic documentation tab, and the initiation of real-time reporting of adverse events. Outcomes included head-of-bed emergency equipment compliance, frequency of a pre-tracheostomy care talk, documentation accuracy in the electronic medical record, and adherence to standards-of-care regarding pediatric patients with tracheostomies.

Results

Interventions were implemented, and data was collected from January 2019 to June 2024. With the implementation of multiple tracheostomy team interventions, head-of-bed emergency equipment compliance increased from 55 % to 100 % over the course of 4 years. Additionally, the frequency of pre-tracheostomy care talks provided to patients scheduled to receive a tracheostomy increased by 400 % over the span of nine months. Changes in documentation accuracy and adherence to standards-of-care were variable.

Conclusions

The pediatric tracheostomy team succeeded in increasing head-of-bed emergency equipment compliance and opportunities for caregiver education. This study demonstrates the additive benefits of a multi-faceted project to improving care in pediatric tracheostomy patients.
采用多学科气管切开术团队,改善儿科患者的护理流程
目的描述一个多学科儿科气管切开术住院团队的不同组成部分(员工教育、系统能力、家庭教育)。方法2019年1月启动后,一家三级儿科医疗中心的多学科气管切开术团队利用精益医学和医疗保健模型改进研究所的混合方法,制定了一项包含多种干预措施的改进计划。干预措施包括教育模块,建立全院协作,调整电子文档标签,以及开始实时报告不良事件。结果包括床头急救设备的依从性、气管切开术前护理谈话的频率、电子病历记录的准确性以及对气管切开术儿科患者护理标准的依从性。结果实施了干预措施,收集了2019年1月至2024年6月的数据。随着多次气管切开术小组干预措施的实施,床头急救设备的依从性在4年内从55%增加到100%。此外,为计划接受气管切开术的患者提供的气管切开术前护理讲座的频率在9个月内增加了400%。在文件准确性和遵守护理标准方面的变化是可变的。结论小儿气管切开术小组成功地提高了床头急救设备的依从性和护理人员教育的机会。本研究表明,一个多方面的项目,以提高护理儿科气管切开术患者的附加效益。
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来源期刊
CiteScore
3.20
自引率
6.70%
发文量
276
审稿时长
62 days
期刊介绍: The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.
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