Development of a Quality Improvement Bundle to Reduce Tracheal Intubation-Associated Events in Pediatric ICUs.

Journal Article (Journal Article;Multicenter Study)

Advanced airway management in the pediatric intensive care unit (PICU) is hazardous, with associated adverse outcomes. This report describes a methodology to develop a bundle to improve quality and safety of tracheal intubations. A prospective observational cohort study was performed with expert consensus opinion of 1715 children undergoing tracheal intubation at 15 PICUs. Baseline process and outcomes data in tracheal intubation were collected using the National Emergency Airway Registry for Children reporting system. Univariate analysis was performed to identify risk factors associated with adverse tracheal intubation-associated events. A multidisciplinary quality improvement committee was formed. Workflow analysis of tracheal intubation and pilot testing were performed to develop the Airway Bundle Checklist with 4 parts: (1) risk factor assessment, (2) plan generation, (3) preprocedure time-out to ensure that providers, equipment, and plans are prepared, (4) postprocedure huddle to identify improvement opportunities. The Airway Bundle Checklist developed may lead to improvement in airway management.

Full Text

Duke Authors

Cited Authors

  • Li, S; Rehder, KJ; Giuliano, JS; Apkon, M; Kamat, P; Nadkarni, VM; Napolitano, N; Thompson, AE; Tucker, C; Nishisaki, A; National Emergency Airway Registry for Children (NEAR4KIDS) Investigators, ; Pediatric Acute Lung Injury and Sepsis Investigator PALISI Network Investigators,

Published Date

  • 2016

Published In

Volume / Issue

  • 31 / 1

Start / End Page

  • 47 - 55

PubMed ID

  • 25143411

Electronic International Standard Serial Number (EISSN)

  • 1555-824X

Digital Object Identifier (DOI)

  • 10.1177/1062860614547259


  • eng

Conference Location

  • Netherlands