Staff-Reported Peri-Procedural Workflow Vulnerabilities and a Preliminary Checklist Prototype for Mechanically...

Area of Science:

• Critical Care Medicine
• Hyperbaric Medicine
• Patient Safety

Background:

• Managing mechanically ventilated patients during hyperbaric oxygen therapy (HBOT) involves complex peri-procedural steps.
• Limited evidence exists on specific workflow vulnerabilities in HBOT patient management.
• This study aimed to identify and address these vulnerabilities through staff-reported observations.

Purpose of the Study:

• To describe staff-reported observations of omitted or delayed tasks during peri-HBOT care for mechanically ventilated patients.
• To use these findings to inform the development of a preliminary checklist prototype for improved workflow.
• To highlight areas for enhanced patient safety and care coordination in HBOT settings.

Main Methods:

• A single-centre pilot survey was conducted at a specialist hyperbaric centre.
• Nineteen healthcare professionals involved in peri-HBOT care completed an anonymous questionnaire.
• Respondents reported observed omissions or incomplete performance of tasks based on one-month retrospective recall.

Main Results:

• Before HBOT, frequent issues included preparation of the intubation set (73.7%) and disconnection of the anti-decubitus mattress pump (42.1%).
• After HBOT, common observations involved replacing air in the endotracheal tube cuff (57.9%) and reconnecting the anti-decubitus mattress pump (52.6%).
• These findings highlight perceived vulnerabilities in the peri-HBOT workflow.

Conclusions:

• The study identified perceived workflow vulnerabilities in peri-HBOT patient management.
• A locally derived checklist prototype was informed by these findings.
• Further usability testing, refinement, and multicentre validation are necessary to confirm checklist effectiveness.