Araceli Cuaranta, Michael Abdelmasseh, Calyb King, Alex Ashley, Jeremy Eckles, Juan Hernandez-Pelcastre, Tania Nguyen, Nic Tate, Chase Gillispie, Joshua Keefer, Levi Nolan, Errington Thompson, Robert Finley, Barbara Payne, Alexei Gorka, Jonathan Willis, Vineela Kadiyala, Juan Sanabria
{"title":"重症监护病房支气管吸入协议在学术卫生网络系统监测。","authors":"Araceli Cuaranta, Michael Abdelmasseh, Calyb King, Alex Ashley, Jeremy Eckles, Juan Hernandez-Pelcastre, Tania Nguyen, Nic Tate, Chase Gillispie, Joshua Keefer, Levi Nolan, Errington Thompson, Robert Finley, Barbara Payne, Alexei Gorka, Jonathan Willis, Vineela Kadiyala, Juan Sanabria","doi":"10.14423/SMJ.0000000000001790","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The objectives were to determine intensive care unit (ICU) incidence of broncho-aspiration (BA) and the effect of monitoring BA prevention protocols.</p><p><strong>Methods: </strong>The Health Network Warehouse was interrogated for the diagnosis of BA in patients older than 18 years in the surgical ICU (SICU) from January 2010 to December 2020. A BA prevention bundle protocol was prospectively monitored during all consecutive SICU admissions from August 2021 to November 2021 until discharge/death (n = 159). Experimental subjects were matched for age, sex, body mass index, and comorbidities with historical controls (BA<sup>-</sup> and BA<sup>+</sup>) as a propensity score analysis study. The BA prevention bundle protocol consisted of head-of-bed elevation at 30°, acid-suppressive medication, and daily administration of mouthwash. Univariate/multivariate analyses were conducted (<i>P</i> < 0.05).</p><p><strong>Results: </strong>The BA incidence over a 10-year period was 5.6%. Before study initiation, random monitoring showed a mean bundle protocol compliance of 29% (18%-39%). After the introduction of protocol monitoring, compliance increased to 92% despite an upsurge in temporary nurses serving in the ICU. There was a total of 795 daily entries, with a mean head-of-bed elevation of 29.8° ± 13°, and a 10-fold decrease in BA (from 5.6% to 0.6%, <i>P</i> < 0.01).</p><p><strong>Conclusions: </strong>Implementation and monitoring of a BA prevention protocol significantly reduced the rate of BA in the SICU.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 2","pages":"128-133"},"PeriodicalIF":1.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801455/pdf/","citationCount":"0","resultStr":"{\"title\":\"ICU-Broncho-Aspiration Protocols Monitoring at an Academic Health Network System.\",\"authors\":\"Araceli Cuaranta, Michael Abdelmasseh, Calyb King, Alex Ashley, Jeremy Eckles, Juan Hernandez-Pelcastre, Tania Nguyen, Nic Tate, Chase Gillispie, Joshua Keefer, Levi Nolan, Errington Thompson, Robert Finley, Barbara Payne, Alexei Gorka, Jonathan Willis, Vineela Kadiyala, Juan Sanabria\",\"doi\":\"10.14423/SMJ.0000000000001790\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The objectives were to determine intensive care unit (ICU) incidence of broncho-aspiration (BA) and the effect of monitoring BA prevention protocols.</p><p><strong>Methods: </strong>The Health Network Warehouse was interrogated for the diagnosis of BA in patients older than 18 years in the surgical ICU (SICU) from January 2010 to December 2020. A BA prevention bundle protocol was prospectively monitored during all consecutive SICU admissions from August 2021 to November 2021 until discharge/death (n = 159). Experimental subjects were matched for age, sex, body mass index, and comorbidities with historical controls (BA<sup>-</sup> and BA<sup>+</sup>) as a propensity score analysis study. The BA prevention bundle protocol consisted of head-of-bed elevation at 30°, acid-suppressive medication, and daily administration of mouthwash. Univariate/multivariate analyses were conducted (<i>P</i> < 0.05).</p><p><strong>Results: </strong>The BA incidence over a 10-year period was 5.6%. Before study initiation, random monitoring showed a mean bundle protocol compliance of 29% (18%-39%). After the introduction of protocol monitoring, compliance increased to 92% despite an upsurge in temporary nurses serving in the ICU. 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ICU-Broncho-Aspiration Protocols Monitoring at an Academic Health Network System.
Objectives: The objectives were to determine intensive care unit (ICU) incidence of broncho-aspiration (BA) and the effect of monitoring BA prevention protocols.
Methods: The Health Network Warehouse was interrogated for the diagnosis of BA in patients older than 18 years in the surgical ICU (SICU) from January 2010 to December 2020. A BA prevention bundle protocol was prospectively monitored during all consecutive SICU admissions from August 2021 to November 2021 until discharge/death (n = 159). Experimental subjects were matched for age, sex, body mass index, and comorbidities with historical controls (BA- and BA+) as a propensity score analysis study. The BA prevention bundle protocol consisted of head-of-bed elevation at 30°, acid-suppressive medication, and daily administration of mouthwash. Univariate/multivariate analyses were conducted (P < 0.05).
Results: The BA incidence over a 10-year period was 5.6%. Before study initiation, random monitoring showed a mean bundle protocol compliance of 29% (18%-39%). After the introduction of protocol monitoring, compliance increased to 92% despite an upsurge in temporary nurses serving in the ICU. There was a total of 795 daily entries, with a mean head-of-bed elevation of 29.8° ± 13°, and a 10-fold decrease in BA (from 5.6% to 0.6%, P < 0.01).
Conclusions: Implementation and monitoring of a BA prevention protocol significantly reduced the rate of BA in the SICU.
期刊介绍：
As the official journal of the Birmingham, Alabama-based Southern Medical Association (SMA), the Southern Medical Journal (SMJ) has for more than 100 years provided the latest clinical information in areas that affect patients'' daily lives. Now delivered to individuals exclusively online, the SMJ has a multidisciplinary focus that covers a broad range of topics relevant to physicians and other healthcare specialists in all relevant aspects of the profession, including medicine and medical specialties, surgery and surgery specialties; child and maternal health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices. Each month, articles span the spectrum of medical topics, providing timely, up-to-the-minute information for both primary care physicians and specialists. Contributors include leaders in the healthcare field from across the country and around the world. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.
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