Logo image
Back
Transition to Routine Premedication for Nonemergent Intubations in a Level IV Neonatal Intensive Care Unit
Journal article   Peer reviewed

Transition to Routine Premedication for Nonemergent Intubations in a Level IV Neonatal Intensive Care Unit

Rachel Fleishman, Roschanak Mossabeb, Ogechukwu Menkiti, Megan Young, Vidhy Bains and David Cooperberg
American journal of perinatology, v 35(4), pp 336-344
Mar 2018
DOI: https://doi.org/10.1055/s-0037-1607282
PMID: 29020695
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Analgesics, Opioid - therapeutic use Female Humans Infant, Newborn Intensive Care, Neonatal - standards Intubation, Intratracheal - adverse effects Male Pain - etiology Pain - prevention & control Practice Guidelines as Topic Premedication - statistics & numerical data Prospective Studies Quality Improvement - organization & administration
This study aims to test whether implementing a guideline for nonemergent intubation improves the rate of premedication for nonemergent intubations in an academic level IV neonatal intensive care unit (NICU). We further sought to test the hypothesis that neonates who receive premedication for a nonemergent intubation have decreased pain scores at the time of intubation, fewer intubation attempts, and no associated adverse events.  This was a prospective observational study with ongoing audit and feedback as well as statistical process control analysis. Data collection began on October 1, 2014. Clinical guideline implementation began in October 2015. A percent "P"-chart spanning seven-quarters was constructed with statistical process control analysis plotting premedication rates over time. Student's -tests or Wilcoxon rank-sum tests were used for secondary outcomes.  The mean number of nonemergent intubations given premedications increased from 34 to 82%. The mean pain score was lower when premedications were given: 0.34 (95% confidence interval [CI]: 0.10-0.58) versus 2.8 (95% CI: 1.9-3.6) (  < 0.001). The number of intubation attempts did not differ with premedications.  Adopting a guideline with supporting educational initiatives to standardize premedication before nonemergent intubations increased this practice. This regimen lowered clinical pain scores with no difference in the number of intubation attempts.

Metrics

19 Record Views
7 citations in Web of Science
8 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

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

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

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