Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May-Jun;37(3):255-265.
doi: 10.1097/JMQ.0000000000000032. Epub 2021 Dec 21.

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

Katherine Finn Davis  1 , Samuel Rosenblatt  2 , Hayley Buffman  3 , Lee Polikoff  4 , Natalie Napolitano  5 , John S Giuliano Jr  6 , Ronald C Sanders Jr  7 , Lauren R Edwards  7 , Ashwin S Krishna  8 , Simon J Parsons  9 , Awni Al-Subu  10 , Conrad Krawiec  11 , Ilana Harwayne-Gidansky  12 , Paula Vanderford  13 , Nina Salfity  14 , Meghan Lane-Fall  15   16 , Vinay Nadkarni  2   3 , Akira Nishisaki  2   3 ; National Emergency Airway Registry for Children (NEAR4KIDS) and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Affiliations

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

Katherine Finn Davis et al. Am J Med Qual. 2022 May-Jun.

Abstract

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.

PubMed Disclaimer

References

    1. Nishisaki A, Turner DA, Brown CA III, et al.; National Emergency Airway Registry for Children (NEAR4KIDS); Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. A National Emergency Airway Registry for children: landscape of tracheal intubation in 15 PICUs. Crit Care Med. 2013;41:874–885.
    1. Graciano AL, Tamburro R, Thompson AE, et al. Incidence and associated factors of difficult tracheal intubations in pediatric ICUs: a report from National Emergency Airway Registry for Children: NEAR4KIDS. Intensive Care Med. 2014;40:1659–1669.
    1. Li S, Hsieh TC, Rehder KJ, et al.; for National Emergency Airway Registry for Children (NEAR4KIDS) and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Frequency of desaturation and association with hemodynamic adverse events during tracheal intubations in PICUs. Pediatr Crit Care Med. 2018;19:e41–e50.
    1. Shiima Y, Berg RA, Bogner HR, et al.; National Emergency Airway Registry for Children Investigators. Cardiac arrests associated with tracheal intubations in PICUs: a multicenter cohort study. Crit Care Med. 2016;44:1675–1682.
    1. Parker MM, Nuthall G, Brown C III, et al. Pediatric acute lung injury and sepsis investigators (PALISI) network. relationship between adverse tracheal intubation associated events and PICU outcomes. Pediatr Crit Care Med. 2017;18:310–318.

Publication types

LinkOut - more resources