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Prevention of unplanned extubations in neonates through process standardization
Journal article   Open access   Peer reviewed

Prevention of unplanned extubations in neonates through process standardization

T D Fontánez-Nieves, M Frost, E Anday, D Davis, D Cooperberg and A J Carey
Journal of perinatology, v 36(6), pp 469-473
Jun 2016
DOI: https://doi.org/10.1038/jp.2015.219
PMID: 26796128
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1038/jp.2015.219View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Airway Extubation - statistics & numerical data Female Humans Infant, Newborn Intensive Care Units, Neonatal - standards Intubation, Intratracheal - adverse effects Intubation, Intratracheal - methods Intubation, Intratracheal - standards Male Outcome and Process Assessment (Health Care) Patient Care Planning - organization & administration Patient-Centered Care - standards Preventive Health Services Quality Improvement Risk Factors Staff Development - methods
Unplanned extubation events (UPEs) in neonates are hazardous to patient safety. Our goal was to reduce UPE rate (#UPEs per 100 ventilator days) by 50% in 12 months at our 25-bed level III inborn unit. Baseline data were gathered prospectively for 7 months. Three Plan-Do-Study-Act (PDSA) cycles targeting main causes of UPEs were developed over the next 20 months. Causes of UPEs were analyzed using Pareto charts; and a U control chart was created with QI Charts(©). Standard rules for detecting special cause variation were applied. Mean UPE rate decreased from 16.1 to 4.5 per 100 ventilator days, a 72% decrease, exceeding our goal. Analysis of U-chart demonstrated special cause variation, with eight consecutive points below the mean. Improvement was sustained throughout the study period. UPEs in neonates can be reduced with process standardization and frontline staff education, emphasizing vigilant endotracheal tube (ETT) maintenance.

Metrics

20 Record Views
33 citations in Web of Science
30 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Obstetrics & Gynecology
Pediatrics
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