Facilitators and Barriers to Implementing Two Quality Improvement Interventions Across 10 Pediatric Intensive Care Units: Video Laryngoscopy-Assisted Coaching and Apneic Oxygenation

被引：5

作者：

Davis, Katherine Finn ^{[1
]}

Rosenblatt, Samuel ^{[2
]}

Buffman, Hayley ^{[3
]}

Polikoff, Lee ^{[4
]}

Napolitano, Natalie ^{[5
]}

Giuliano, John S., Jr. ^{[6
]}

Sanders, Ronald C., Jr. ^{[7
]}

Edwards, Lauren R. ^{[7
]}

Krishna, Ashwin S. ^{[8
]}

Parsons, Simon J. ^{[9
]}

Al-Subu, Awni ^{[10
]}

Krawiec, Conrad ^{[11
]}

Harwayne-Gidansky, Ilana ^{[12
]}

Vanderford, Paula ^{[13
]}

Salfity, Nina ^{[14
]}

Lane-Fall, Meghan ^{[15
,16
]}

Nadkarni, Vinay ^{[2
,3
]}

Nishisaki, Akira ^{[2
,3
]}

机构：

[1] Univ Hawaii Manoa, Sch Nursing & Dent Hyg, Honolulu, HI 96822 USA

[2] Childrens Hosp Philadelphia, Dept Anesthesiol & Crit Care Med, Philadelphia, PA 19104 USA

[3] Childrens Hosp Philadelphia, Ctr Simulat Adv Educ & Innovat, Philadelphia, PA 19104 USA

[4] Brown Univ, Warren Alpert Sch Med, Div Pediat Crit Care Med, Providence, RI 02912 USA

[5] Childrens Hosp Philadelphia, Dept Resp Therapy, Philadelphia, PA 19104 USA

[6] Yale Univ, Sch Med, Dept Pediat, Sect Pediat Crit Care Med, New Haven, CT 06510 USA

[7] Arkansas Childrens Hosp, Dept Pediat, Sect Crit Care, Little Rock, AR 72202 USA

[8] Univ Kentucky, Sch Med, Kentucky Childrens Hosp, Dept Pediat,Div Pediat Crit Care, Lexington, KY 40536 USA

[9] Alberta Childrens Prov Gen Hosp, Dept Pediat, Sect Crit Care Med, Calgary, AB, Canada

[10] Univ Wisconsin, Dept Pediat, Amer Family Childrens Hosp, Div Pediat Crit Care Med, Madison, WI USA

[11] Penn State Hershey Childrens Hosp, Dept Pediat & Publ Hlth Sci, Div Pediat Crit Care Med, Hershey, PA USA

[12] Stony Brook Childrens Hosp, Pediat Crit Care Med, Stony Brook, NY USA

[13] Doernbecher Childrens Hosp, Div Pediat Crit Care Med, Portland, OR USA

[14] Phoenix Childrens Hosp, Div Crit Care, Phoenix, AZ USA

[15] Univ Penn, Perelman Sch Med, Dept Anesthesiol & Crit Care Med, Philadelphia, PA 19104 USA

[16] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA

来源：

AMERICAN JOURNAL OF MEDICAL QUALITY | 2022年 / 37卷 / 03期

基金：

美国医疗保健研究与质量局;

关键词：

pediatrics; qualitative research; quality improvement; INSUFFLATION VENTILATORY EXCHANGE; EMERGENCY AIRWAY REGISTRY; INTUBATION-ASSOCIATED EVENTS; TRACHEAL INTUBATION; SEQUENCE INTUBATION; CHILDREN; DESATURATION; MULTICENTER; PREOXYGENATION; OUTCOMES;

D O I：

10.1097/JMQ.0000000000000032

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

To better understand facilitators and barriers to implementation of quality improvement (QI) efforts, this study examined 2 evidence-based interventions, video laryngoscopy (VL)-assisted coaching, and apneic oxygenation (AO). One focus group with frontline clinicians was held at each of the 10 participating pediatric intensive care units. Qualitative analysis identified common and unique themes. Intervention fidelity was monitored with a priori defined success as >50% VL-assisted coaching or >80% AO use for 3 consecutive months. Eighty percent of intensive care units with VL-assisted coaching and 20% with AO met this criteria during the study period. Common facilitator themes were adequate device accessibility, having a QI culture, and strong leadership. Common barrier themes included poor device accessibility and perception of delay in care. A consistently identified theme in the successful sites was strong QI leadership, while unsuccessful sites consistently identified insufficient education. These facilitators and barriers should be proactively addressed during dissemination of these interventions.

引用

页码：255 / 265

页数：11

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