Emily R Hamilton, Marketa Rejtar, Michele DeGrazia, Youyang Yang
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Failure Modes and Effects Analysis to Evaluate Discharge Delays of Postoperative Tonsillectomy Patients From the Medical-Surgical PICU.
Background: Discharge delays of Medical-Surgical Pediatric Intensive Care Unit (PICU) patients with Obstructive Sleep Apnea (OSA) following tonsillectomy or tonsillectomy with adenoidectomy (T&A) negatively impact hospital bed availability.
Aim statement: This project identified process improvements to reduce discharge delays and increase PICU bed availability.
Methods: A Failure Modes and Effects Analysis (FMEA) was implemented to identify care and process failures that result in discharge delays.
Intervention: Through the FMEA, failure risk profile numbers with the highest impact were recognized for improvement (Institute for Healthcare Improvement, 2017; VHA National Center for Patient Safety, 2023).
Results: Forty failure modes were identified. High-impact failures included not administering dexamethasone early for patient pain or desaturation, intervening for desaturations consistent with the patient's baseline, and not anticipating family needs for discharge.
Conclusions: The FMEA identified several actionable changes that if implemented, could promote timely discharge of patients with OSA following tonsillectomy or T&A.
期刊介绍：
The Journal of Pediatric Health Care, the official journal of the National Association of Pediatric Nurse Practitioners, provides scholarly clinical information and research regarding primary, acute and specialty health care for children of newborn age through young adulthood within a family-centered context. The Journal disseminates multidisciplinary perspectives on evidence-based practice and emerging policy, advocacy and educational issues that are of importance to all healthcare professionals caring for children and their families.
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