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

Background: Peri-procedural management of mechanically ventilated intensive care unit (ICU) patients undergoing hyperbaric oxygen therapy (HBOT) requires coordinated preparation, chamber-compatible equipment management, transfer readiness, and restoration of standard ICU support. Evidence on HBOT-specific workflow vulnerabilities remains limited. This single-centre pilot survey described staff-reported observations of omitted, delayed, or incompletely performed peri-HBOT tasks and used them to inform a preliminary checklist prototype. Methods: Nineteen healthcare professionals involved in peri-HBOT care at a specialist hyperbaric centre in Poland completed an anonymous questionnaire based on one-month retrospective recall. Respondents indicated whether they had observed each listed task being omitted or incompletely performed at least once. Analyses used respondent-level counts, percentages, and Wilson 95% confidence intervals. Results: Before HBOT, the most frequently reported observations concerned preparation of the intubation set for transfer (14/19, 73.7%; 95% CI: 51.2-88.2), disconnection of the anti-decubitus mattress pump (8/19, 42.1%; 95% CI: 23.1-63.7), removal or replacement of hazardous bed materials (7/19, 36.8%; 95% CI: 19.1-59.0), and preparation of the self-inflating bag (6/19, 31.6%; 95% CI: 15.4-54.0). After HBOT, observations most often involved replacing fluid with air in the endotracheal tube cuff (11/19, 57.9%; 95% CI: 36.3-76.9), reconnecting the anti-decubitus mattress pump (10/19, 52.6%; 95% CI: 31.7-72.7), and reconnecting interrupted intravenous infusions (5/19, 26.3%; 95% CI: 11.8-48.8). Conclusions: Findings identified perceived peri-HBOT workflow vulnerabilities and informed a locally derived checklist prototype. They should not be interpreted as verified omission prevalence, event rates, patient harm, or checklist effectiveness; usability testing, refinement, and multicentre validation are required.