Comprehensive Airway Quality Improvement Program: Reducing Life-Threatening Airway Complications.

Autor:	Helmen ZM; Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA., Larkin R; Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA., Peifer S; Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA., Escanelle MA; Department of Anesthesiology, University of Miami Miller School of Medicine, Perioperative Medicine, and Pain Management, Miami, FL, USA., Hall AWM; Department of Anesthesiology, University of Miami Miller School of Medicine, Perioperative Medicine, and Pain Management, Miami, FL, USA., Luka T; Department of Pulmonary Medicine, University of Miami Miller School of Medicine, Miami, FL, USA., De Varona C; Department of Pulmonary Medicine, University of Miami Miller School of Medicine, Miami, FL, USA., Hombreiro P; Department of Pulmonary Medicine, University of Miami Miller School of Medicine, Miami, FL, USA., Farrell J; Department of Nursing, University of Miami Hospital, Miami, FL, USA., McClure B; Department of Nursing, University of Miami Hospital, Miami, FL, USA., Harris M; Department of Nursing, University of Miami Hospital, Miami, FL, USA., Ruche A; Department of Nursing, University of Miami Hospital, Miami, FL, USA., Levy D; Department of Nursing, University of Miami Hospital, Miami, FL, USA., Falise JP; Department of Nursing, University of Miami Hospital, Miami, FL, USA., Ashley D; Department of Nursing, University of Miami Hospital, Miami, FL, USA., Gabrielli A; Department of Anesthesiology, University of Miami Miller School of Medicine, Perioperative Medicine, and Pain Management, Miami, FL, USA., Sosa MA; Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA., Sargi Z; Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA., Ruiz JW; Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA., Arnold DJ; Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA., Ferreira T; Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, Miami, FL, USA., Nicolli E; Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
Jazyk:	angličtina
Zdroj:	The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2024 Dec; Vol. 133 (12), pp. 1010-1018. Date of Electronic Publication: 2024 Oct 06.
DOI:	10.1177/00034894241285236
Abstrakt:	Objective: There is often unfamiliarity with the care of artificial airway devices (ie, endotracheal tubes, tracheostomies, and laryngectomies). The objective of this study was to design an Airway Quality Improvement Program (AQIP) to improve airway care. Methods: This was a retrospective chart review of a prospectively-initiated AQIP. The AQIP has 3 parts: 1) Mandatory "airway signs" 2) In-service teaching with a corresponding order set and 3) an overhead "Surgical Airway Emergency" page involving automatic pages to Anesthesia, Otolaryngology, and Respiratory Therapy. Pre- and post-intervention survey data was collected. The incidence of airway emergency was the primary patient outcome and was hypothesized to decrease after AQIP intervention. Results: Airway emergencies decreased 8.4% after AQIP ( P  = .45). Length of stay decreased after AQIP, 47.0 ± 76.5 days compared to 23.5 ± 23.6 ( P  = .004). Two hundred eight-one nurses and 76 respiratory therapists were educated. Pre-AQIP comfortability scores improved for the routine care of endotracheal tubes, tracheostomies, and laryngectomies, 4.3 ± 0.9, 4.3 ± 0.8, and 3.5 ± 1.2, compared to 4.7 ± 0.6, 4.5 ± 0.7, and 4.4 ± 0.7 post-AQIP ( P  = .0006, P  = .02, P  = .0001). The same improvement was noted for emergency airway care. Tracheostomy vs. laryngectomy recognition increased from 66.5 to 97.0% ( P  = .0001). Quiz questions regarding emergency airway management for laryngectomies improved from 76.2 to 93.8% ( P  = .0001). Conclusion: The AQIP was associated with decreased length of hospital stay and improved competency in airway care among hospital staff. Further application of AQIP is needed for replication in other institutions and long-term application. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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