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Structured Documentation of Home Ventilator Settings in Children: A Quality Improvement Project

Michelle K Joyner, Folashade C Afolabi, Tessa L Payne

    Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
    |June 21, 2016
    PubMed

    Insights

    A new documentation tool for home long-term mechanical ventilation (LTMV) settings improved nurse communication and patient safety. Adverse events decreased significantly, demonstrating the tool's effectiveness in clinical practice.

    Area of Science:

    • Pediatric critical care medicine
    • Respiratory therapy
    • Health informatics

    Background:

    • Insufficient charting of home long-term mechanical ventilation (LTMV) settings in pediatric patients can lead to adverse events.
    • Effective communication and documentation are crucial for patient safety in LTMV care.

    Purpose of the Study:

    • To develop and assess a structured documentation tool for home LTMV settings.
    • To enhance communication, documentation quality, and patient safety for children on LTMV.

    Main Methods:

    • A pretest-posttest survey evaluated nurses' satisfaction and perceptions of patient safety.
    • Chart reviews assessed documentation compliance.
    • Analysis included Mann-Whitney U tests, Fisher exact tests, and descriptive statistics.

    Main Results:

    • Positive communication regarding LTMV settings increased from 54.5% to 100% (p=0.002).
    • Overall satisfaction with documentation improved significantly (p<0.001).
    • Witnessed adverse events decreased from 50% to 18.75%.

    Conclusions:

    • Structured admission charting of LTMV settings is recommended for continued use.
    • The tool demonstrably improved nurse perceptions of communication, patient safety, and documentation compliance.
    Abstract

    Keywords:
    Ventilatorcommunicationquality improvementsafetystructured documentation

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