The NICU tracheostomy team: multidisciplinary collaboration for improvement in survival of complex patients.
J Perinatol
; 2024 Jun 24.
Article
in En
| MEDLINE
| ID: mdl-38914748
ABSTRACT
OBJECTIVE:
Evaluate feasibility and impact of "Tracheostomy Team" on survival and length of stay (LOS) at a level IV NICU.METHODS:
Plan-do-study-act cycles targeted five Global Tracheostomy Collaborative "key drivers". From January 2017 to December 2022 multidisciplinary, bimonthly bedside rounds were conducted.RESULTS:
After 3 cycles, in-hospital survival among 39 patients with tracheostomy improved and sustained from 67% to 100% (baseline 18/27; 66.7%; QI 35/39, 89.7%; p = 0.03). Median LOS (days [IQR]) did not significantly differ between baseline and QI (237 [57-308] vs. 217 [130-311]; p = 0.9). Among patients with BPD, median LOS was higher after QI interventions (baseline 248 [222-308] vs. QI 332.5 [283.5-392]; p = .02). Special cause variation resulted from peak increase in LOS during the COVID19 pandemic (2021). Tracheitis/pneumonia was treated significantly more frequently in QI BPD patients.CONCLUSION:
Multidisciplinary approach is feasible, resulting in improved survival without a sustained increase in LOS. Future QI efforts should address post-operative infectious complications.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Perinatol
Journal subject:
PERINATOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Estados Unidos