Tronnier Amy, Mulcahy Collin F, Pierce Ayal, Benjenk Ivy, Sherman Marian, Heinz Eric R, Honeychurch Scott, Ho Geoffrey, Talton Kendarius, Yamane David
The George Washington University, Washington, DC The George Washington University Hospital, Washington, DC.
Am J Med Qual. 2020 Dec;35(6):450-457. doi: 10.1177/1062860620949141. Epub 2020 Aug 18.
The COVID-19 pandemic has forced the health care industry to develop dynamic protocols to maximize provider safety as aerosolizing procedures, specifically intubation, increase the risk of contracting SARS-CoV-2. The authors sought to create a quality improvement framework to ensure safe practices for intubating providers, and describe a multidisciplinary model developed at an academic tertiary care facility centered on rapid-cycle improvements and real-time gap analysis to track adherence to COVID-19 intubation safety protocols. The model included an Intubation Safety Checklist, a standardized documentation template for intubations, obtaining real-time feedback, and weekly multidisciplinary team meetings to review data and implement improvements. This study captured 68 intubations in suspected COVID-19 patients and demonstrated high personal protective equipment compliance at the institution, but also identified areas for process improvement. Overall, the authors posit that an interdisciplinary workgroup and the integration of standardized processes can be used to enhance intubation safety among providers during the COVID-19 pandemic.
新冠疫情迫使医疗行业制定动态协议，以在雾化操作（尤其是插管）增加感染新冠病毒风险的情况下，最大限度提高医护人员的安全性。作者试图创建一个质量改进框架，以确保插管医护人员的安全操作，并描述了在一家学术性三级医疗机构开发的多学科模型，该模型以快速循环改进和实时差距分析为核心，以跟踪对新冠插管安全协议的遵守情况。该模型包括一份插管安全检查表、一个用于插管的标准化文档模板、获取实时反馈，以及每周举行多学科团队会议以审查数据并实施改进。本研究记录了68例疑似新冠患者的插管情况，显示该机构个人防护装备的合规率很高，但也确定了流程改进的领域。总体而言，作者认为跨学科工作组和标准化流程的整合可用于在新冠疫情期间提高医护人员的插管安全性。
