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Compassionate extubation protocol to improve team communication and support in the neonatal intensive care unit

OBJECTIVE: Compassionate extubation (CE) can be stressful for staff and families in the neonatal intensive care unit (NICU). Our quality improvement initiative developed and implemented a novel symptom management and family support checklist and post-debriefing template to improve team communication...

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Detalles Bibliográficos
Autores principales: Donoho, Kelsey, Fossa, Mallory, Dabagh, Sarah, Caliboso, Menchie, Lotstein, Debra, Nair, Srikumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129605/
https://www.ncbi.nlm.nih.gov/pubmed/34006968
http://dx.doi.org/10.1038/s41372-021-01085-8
Descripción
Sumario:OBJECTIVE: Compassionate extubation (CE) can be stressful for staff and families in the neonatal intensive care unit (NICU). Our quality improvement initiative developed and implemented a novel symptom management and family support checklist and post-debriefing template to improve team communication and staff support. STUDY DESIGN: An interprofessional team performed a needs assessment, determined key drivers and intervention steps, and implemented changes using Plan-Do-Study-Act cycles. Outcomes included nursing perception of good communication with the medical team, nursing assessment of patient comfort after CE, and frequency of post-event debrief. Outcomes were analyzed using time series design with 12 months baseline data and 6 months post-implementation monitoring. RESULT: Eighteen events were studied. Respondents endorsing “good” communication with the medical team increased by 60%, and debrief participation rate improved by 96%. CONCLUSION: Implementation of a CE checklist and post-event debriefing sheet was associated with increased rate of debriefs and improved team communication.