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

Area of Science:

• Pediatric Critical Care Medicine
• Quality Improvement in Healthcare
• Airway Management

Background:

• Advanced airway management in the pediatric intensive care unit (PICU) carries significant risks and adverse outcomes.
• Tracheal intubation is a common but hazardous procedure in critically ill children.

Purpose of the Study:

• To develop a methodology for creating a quality improvement bundle to enhance the safety of tracheal intubations.
• To introduce the Airway Bundle Checklist designed to standardize and improve airway management.

Main Methods:

• A prospective observational cohort study involving 1715 children across 15 PICUs.
• Utilized expert consensus and the National Emergency Airway Registry for Children for data collection.
• Conducted workflow analysis and pilot testing to develop a 4-part Airway Bundle Checklist.

Main Results:

• Identified risk factors associated with adverse tracheal intubation events through univariate analysis.
• Developed a comprehensive Airway Bundle Checklist incorporating risk assessment, planning, pre-procedure checks, and post-procedure review.
• The checklist is designed to systematically address potential complications.

Conclusions:

• The developed Airway Bundle Checklist offers a structured approach to improve airway management quality and safety.
• Implementation of this checklist has the potential to reduce adverse events during pediatric tracheal intubations.
• This methodology provides a framework for quality improvement in critical care airway procedures.