Improving delivery of low tidal volume ventilation in 10 ICUs

BMJ Open Quality

article

Chenell Donadee¹  Mark Cohen-Melamed²  Edgar Delgado²  Scott R Gunn¹ 

[1] Department of Critical Care Medicine , University of Pittsburgh;Respiratory Care Department , University of Pittsburgh Medical Center

关键词: critical care;    healthcare quality improvement;    PDSA;    quality improvement;   

DOI  :  10.1136/bmjoq-2021-001343

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

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.critical carehealthcare quality improvementPDSAquality improvementData availability statementData are available upon request.http://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/.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND