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Improving delivery of low tidal volume ventilation in 10 ICUs

Low tidal volume ventilation (LTVV) is standard of care for mechanically ventilated patients with acute respiratory distress syndrome and has been shown to improve outcomes in the general mechanically ventilated population. Despite these improved outcomes, in clinical practice the LTVV standard of c...

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Autores principales: Donadee, Chenell, Cohen-Melamed, Mark, Delgado, Edgar, Gunn, Scott R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808457/
https://www.ncbi.nlm.nih.gov/pubmed/35105549
http://dx.doi.org/10.1136/bmjoq-2021-001343
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author Donadee, Chenell
Cohen-Melamed, Mark
Delgado, Edgar
Gunn, Scott R
author_facet Donadee, Chenell
Cohen-Melamed, Mark
Delgado, Edgar
Gunn, Scott R
author_sort Donadee, Chenell
collection PubMed
description Low tidal volume ventilation (LTVV) is standard of care for mechanically ventilated patients with acute respiratory distress syndrome and has been shown to improve outcomes in the general mechanically ventilated population. Despite these improved outcomes, in clinical practice the LTVV standard of care is often not met. We aimed to increase compliance with LTVV in mechanically ventilated patients in 10 intensive care units at 3 hospitals within the University of Pittsburgh School of Medicine Department of Critical Care Medicine. Four Plan-Do-Study-Act (PDSA) cycles were implemented to improve compliance with LTVV. Initial compliance rates of 40.6%–60.1% improved to 91%–96% by the end of the fourth PDSA cycle. The most impactful step in the intervention was providing education and giving responsibility of selecting the tidal volume to the respiratory therapist. The overall intervention resulted in improved compliance with LTVV that has been sustained for multiple years after our active PDSA cycles.
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spelling pubmed-88084572022-02-09 Improving delivery of low tidal volume ventilation in 10 ICUs Donadee, Chenell Cohen-Melamed, Mark Delgado, Edgar Gunn, Scott R BMJ Open Qual Quality Improvement Report Low tidal volume ventilation (LTVV) is standard of care for mechanically ventilated patients with acute respiratory distress syndrome and has been shown to improve outcomes in the general mechanically ventilated population. Despite these improved outcomes, in clinical practice the LTVV standard of care is often not met. We aimed to increase compliance with LTVV in mechanically ventilated patients in 10 intensive care units at 3 hospitals within the University of Pittsburgh School of Medicine Department of Critical Care Medicine. Four Plan-Do-Study-Act (PDSA) cycles were implemented to improve compliance with LTVV. Initial compliance rates of 40.6%–60.1% improved to 91%–96% by the end of the fourth PDSA cycle. The most impactful step in the intervention was providing education and giving responsibility of selecting the tidal volume to the respiratory therapist. The overall intervention resulted in improved compliance with LTVV that has been sustained for multiple years after our active PDSA cycles. BMJ Publishing Group 2022-02-01 /pmc/articles/PMC8808457/ /pubmed/35105549 http://dx.doi.org/10.1136/bmjoq-2021-001343 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Quality Improvement Report
Donadee, Chenell
Cohen-Melamed, Mark
Delgado, Edgar
Gunn, Scott R
Improving delivery of low tidal volume ventilation in 10 ICUs
title Improving delivery of low tidal volume ventilation in 10 ICUs
title_full Improving delivery of low tidal volume ventilation in 10 ICUs
title_fullStr Improving delivery of low tidal volume ventilation in 10 ICUs
title_full_unstemmed Improving delivery of low tidal volume ventilation in 10 ICUs
title_short Improving delivery of low tidal volume ventilation in 10 ICUs
title_sort improving delivery of low tidal volume ventilation in 10 icus
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808457/
https://www.ncbi.nlm.nih.gov/pubmed/35105549
http://dx.doi.org/10.1136/bmjoq-2021-001343
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