Journal of perinatology : official journal of the California Perinatal Association · 2022
Improving management of ventilator associated tracheitis in a level IV NICU.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ingolfsland Ellen C, Gonzalez-Villamizar Juan David, Moore Jeanne, Kubly Janet, Ali Hawa M, Kvant Ann, Smith Betsy, Norton Laura
Аннотация
BACKGROUND: There are no published guidelines regarding the diagnosis and treatment of ventilator-associated tracheitis (VAT) in the neonatal intensive care unit (NICU). VAT is likely over-diagnosed and over-treated, increasing antibiotic burden and cost.
LOCAL PROBLEM: Diagnosis and treatment of VAT were entirely NICU provider dependent.
METHODS: Retrospective pre- and post-intervention chart reviews were performed.
INTERVENTIONS: A VAT diagnosis and treatment algorithm was created for use in the care of intubated patients without tracheostomies. 3 plan-do-study-act (PDSA) cycles were used to implement change.
RESULTS: Intubated patients treated for VAT with <25 PMNs on Gram stain decreased from 79% to 35% following the quality improvement (QI) initiative. Treatment of VAT with >7 days of antibiotic therapy decreased from 42% to 10%.
CONCLUSION: Implementing a QI initiative to improve the diagnosis and treatment of VAT in the NICU decreased the percent of patients treated inappropriately for VAT.
LOCAL PROBLEM: Diagnosis and treatment of VAT were entirely NICU provider dependent.
METHODS: Retrospective pre- and post-intervention chart reviews were performed.
INTERVENTIONS: A VAT diagnosis and treatment algorithm was created for use in the care of intubated patients without tracheostomies. 3 plan-do-study-act (PDSA) cycles were used to implement change.
RESULTS: Intubated patients treated for VAT with <25 PMNs on Gram stain decreased from 79% to 35% following the quality improvement (QI) initiative. Treatment of VAT with >7 days of antibiotic therapy decreased from 42% to 10%.
CONCLUSION: Implementing a QI initiative to improve the diagnosis and treatment of VAT in the NICU decreased the percent of patients treated inappropriately for VAT.