Quality Improvement Study on New Endotracheal Tube Securing Device (Neobar) in Neonates

Area of Science:

• Neonatal intensive care
• Medical device safety
• Quality improvement in healthcare

Background:

• Unplanned extubation (UE) is a significant concern in neonatal intensive care units (NICUs).
• Securing endotracheal tubes (ETTs) effectively is crucial for preventing UE.
• The NeoBar device was introduced as a potential improvement over traditional ETT taping methods.

Purpose of the Study:

• To compare the rate of unplanned extubation (UE) after introducing the NeoBar device versus the previous taping method.
• To identify factors contributing to UE in the NICU setting.

Main Methods:

• A quality improvement study in a tertiary NICU from October 2011 to December 2013.
• Comparison of UE rates (per 100 intubation days) one year before and one year after NeoBar implementation.
• Utilized statistical process control charts and Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines.

Main Results:

• The UE rate slightly decreased from 1.47 to 1.17 per 100 intubation days post-NeoBar introduction (p=0.91).
• The change in UE rate was not statistically significant, but showed a stable trend.
• Common UE factors included ETT retaping, infant agitation, and concurrent procedures.

Conclusions:

• NeoBar use was associated with comparable UE rates to the taping method.
• Larger prospective studies are necessary to definitively assess NeoBar's efficacy in reducing UE.