Quality Improvement Initiative in Pediatric Critical Care

Miranda Marie Schmidt

doi:doi:10.11648/j.ajp.20220802.14

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Quality Improvement Initiative in Pediatric Critical Care

Miranda Marie Schmidt

Published in American Journal of Pediatrics (Volume 8, Issue 2)

Received: 14 March 2022 Accepted: 6 April 2022 Published: 14 April 2022

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Abstract

In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of improvement strategies aimed at reducing hospital acquired pressure injury and decannulations. During this two-year time 150 nursing surveys and comprehensive literature reviews were completed to identify best practices and essential learning needs of the staff. The outcomes of these reviews helped to create improvement strategies which included developing educational initiatives focused on to support specific pathophysiologic issues impacting morbidity of patients leading to the quality metric goals. Upon completion of the educational and training initiatives led by the specialty care team, the incidence in tracheostomy decannulations and pressure injuries reduced significantly. Conclusions from this work highlight the importance of frontline staff as pivotal leaders in process change management and quality improvement changes. The teamwork among the interdisciplinary members allowed for enhanced collaboration in improving patient care outcomes and remains an active forum for evaluation of improvement in patient care. The efforts of the specialty care team provided sufficient data to support the implementation of specialty care teams that align efforts with that of organizational goals and aimed at reducing patient harm.

Published in	American Journal of Pediatrics (Volume 8, Issue 2)
DOI	10.11648/j.ajp.20220802.14
Page(s)	70-76
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Pediatric Critical Care, Nursing Education, Quality Improvement, Tracheostomy Decannulation, Pressure Injury Prevention

References

[1]	Abode, K. A., Drake, A. F., Zdanksi, C. J., Retsch-Bogart, G. Z., Gee, A. B., Noah, T. L. (2016). A multidisciplinary children’s airway center: impact on the care of patients with tracheostomy. Pediatrics. 137 (2).
[2]	Ballangrud, R., Persenius, M., Hedelin, B., & Hall-Lord, M. L. (2014). Exploring intensive care nurses’ team performance in a simulation-based emergency situation, - expert raters’ assessments versus self-assessments: an explorative study. BMC Nursing, 13 (1), 1-22. doi: 10.1186/s12912-014-0047-5.
[3]	Boesch, R. P., Myers, C., Garrett, T., Nie, A. M., Thomas, N., Chima, et al., (2012) Prevention of Tracheostomy- related Pressure Ulcers in Children. Pediatrics 129 (3).
[4]	Chamberlain College of Nursing (2016) Kotter’s Change Model ®. Eight steps to implementing change. Retrieved on March 25, 2016, from http://my.chamberlain.edu
[5]	Itamoto, C. H., Lima, B. T., Sato, J., Fujita, R. R., (2010) Indications and Complications of Tracheostomy in Children. Brazilian Journal of Otorhinolaryngology. 76 (3) 326-331.
[6]	McCaleb, R., Warren, R. H., Willis, D., Maples, H. D., Bai, S., O’Brien, C. E., (2016) Description of Respiratory Microbiology of Children with long-term tracheostomies. Respiratory Care 61 (4).
[7]	McClean, E. B., (2012) Tracheal suctioning in children with chronic tracheostomies: A Pilot study applying suction both while inserting and removing the catheter. Journal of Pediatric Nursing 27, 50-54.
[8]	Mok, Q., (2012) Tracheostomies in Pediatric Intensive Care: Evolving indications and Changing Expectations. Arch Dis Child 97 (858-859).
[9]	Morris, L., Whitmer, A., McIntosh, E., (2013) Tracheostomy care and complications in the intensive care unit. Critical Care Nurse 33 (5) 18-30 doi: 10.4037/ccn2013518.
[10]	Orr, R., Venkataraman, S., Seidberg, N., Dragotta, M., McCloskey, K., & Janosky, L. (n.d). Pediatric specialty care teams are associated with reduced morbidity during pediatric interfacility transport. Critical Care Medicine, 27 (1), A30.
[11]	Overman, A. E., et al., (2013) Tracheostomy for infants requiring prolonged mechanical ventilation: 10 years’ experience. Pediatrics. 131 (5)
[12]	Rachman, B., Watson, R., Woods, N., Mink, R., (2009) Reducing Unplanned Extubations in a Pediatric Intensive Care Unit: A Systematic Approach. International Journal of Pediatrics. doi: 10.115/2009/820495.
[13]	Serhal, M., et al., (2017) Review of decannulation of tracheostomies in children. Nihon Kikan Shokudoka Gakkai Kaiho, 66 (4) 255-261 doi: 10.2468/jbes.66.255.
[14]	Wilfond, B. S., (2014) Tracheostomies and assisted ventilation in children with profound disabilities: Navigating family and professional values. Pediatrics 133 (1).

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APA Style

Miranda Marie Schmidt. (2022). Quality Improvement Initiative in Pediatric Critical Care. American Journal of Pediatrics, 8(2), 70-76. https://doi.org/10.11648/j.ajp.20220802.14

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ACS Style

Miranda Marie Schmidt. Quality Improvement Initiative in Pediatric Critical Care. Am. J. Pediatr. 2022, 8(2), 70-76. doi: 10.11648/j.ajp.20220802.14

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AMA Style

Miranda Marie Schmidt. Quality Improvement Initiative in Pediatric Critical Care. Am J Pediatr. 2022;8(2):70-76. doi: 10.11648/j.ajp.20220802.14

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@article{10.11648/j.ajp.20220802.14,
  author = {Miranda Marie Schmidt},
  title = {Quality Improvement Initiative in Pediatric Critical Care},
  journal = {American Journal of Pediatrics},
  volume = {8},
  number = {2},
  pages = {70-76},
  doi = {10.11648/j.ajp.20220802.14},
  url = {https://doi.org/10.11648/j.ajp.20220802.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220802.14},
  abstract = {In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of improvement strategies aimed at reducing hospital acquired pressure injury and decannulations. During this two-year time 150 nursing surveys and comprehensive literature reviews were completed to identify best practices and essential learning needs of the staff. The outcomes of these reviews helped to create improvement strategies which included developing educational initiatives focused on to support specific pathophysiologic issues impacting morbidity of patients leading to the quality metric goals. Upon completion of the educational and training initiatives led by the specialty care team, the incidence in tracheostomy decannulations and pressure injuries reduced significantly. Conclusions from this work highlight the importance of frontline staff as pivotal leaders in process change management and quality improvement changes. The teamwork among the interdisciplinary members allowed for enhanced collaboration in improving patient care outcomes and remains an active forum for evaluation of improvement in patient care. The efforts of the specialty care team provided sufficient data to support the implementation of specialty care teams that align efforts with that of organizational goals and aimed at reducing patient harm.},
 year = {2022}
}

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TY  - JOUR
T1  - Quality Improvement Initiative in Pediatric Critical Care
AU  - Miranda Marie Schmidt
Y1  - 2022/04/14
PY  - 2022
N1  - https://doi.org/10.11648/j.ajp.20220802.14
DO  - 10.11648/j.ajp.20220802.14
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 70
EP  - 76
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20220802.14
AB  - In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of improvement strategies aimed at reducing hospital acquired pressure injury and decannulations. During this two-year time 150 nursing surveys and comprehensive literature reviews were completed to identify best practices and essential learning needs of the staff. The outcomes of these reviews helped to create improvement strategies which included developing educational initiatives focused on to support specific pathophysiologic issues impacting morbidity of patients leading to the quality metric goals. Upon completion of the educational and training initiatives led by the specialty care team, the incidence in tracheostomy decannulations and pressure injuries reduced significantly. Conclusions from this work highlight the importance of frontline staff as pivotal leaders in process change management and quality improvement changes. The teamwork among the interdisciplinary members allowed for enhanced collaboration in improving patient care outcomes and remains an active forum for evaluation of improvement in patient care. The efforts of the specialty care team provided sufficient data to support the implementation of specialty care teams that align efforts with that of organizational goals and aimed at reducing patient harm.
VL  - 8
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ER  -

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Author Information

Miranda Marie Schmidt

Center for Professional Excellence and Inquiry, Stanford Lucile Packard Children’s Hospital, Palo Alto, United States

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APA Style

Miranda Marie Schmidt. (2022). Quality Improvement Initiative in Pediatric Critical Care. American Journal of Pediatrics, 8(2), 70-76. https://doi.org/10.11648/j.ajp.20220802.14

Copy | Download

ACS Style

Miranda Marie Schmidt. Quality Improvement Initiative in Pediatric Critical Care. Am. J. Pediatr. 2022, 8(2), 70-76. doi: 10.11648/j.ajp.20220802.14

Copy | Download

AMA Style

Miranda Marie Schmidt. Quality Improvement Initiative in Pediatric Critical Care. Am J Pediatr. 2022;8(2):70-76. doi: 10.11648/j.ajp.20220802.14

Copy | Download

@article{10.11648/j.ajp.20220802.14,
  author = {Miranda Marie Schmidt},
  title = {Quality Improvement Initiative in Pediatric Critical Care},
  journal = {American Journal of Pediatrics},
  volume = {8},
  number = {2},
  pages = {70-76},
  doi = {10.11648/j.ajp.20220802.14},
  url = {https://doi.org/10.11648/j.ajp.20220802.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220802.14},
  abstract = {In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of improvement strategies aimed at reducing hospital acquired pressure injury and decannulations. During this two-year time 150 nursing surveys and comprehensive literature reviews were completed to identify best practices and essential learning needs of the staff. The outcomes of these reviews helped to create improvement strategies which included developing educational initiatives focused on to support specific pathophysiologic issues impacting morbidity of patients leading to the quality metric goals. Upon completion of the educational and training initiatives led by the specialty care team, the incidence in tracheostomy decannulations and pressure injuries reduced significantly. Conclusions from this work highlight the importance of frontline staff as pivotal leaders in process change management and quality improvement changes. The teamwork among the interdisciplinary members allowed for enhanced collaboration in improving patient care outcomes and remains an active forum for evaluation of improvement in patient care. The efforts of the specialty care team provided sufficient data to support the implementation of specialty care teams that align efforts with that of organizational goals and aimed at reducing patient harm.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Quality Improvement Initiative in Pediatric Critical Care
AU  - Miranda Marie Schmidt
Y1  - 2022/04/14
PY  - 2022
N1  - https://doi.org/10.11648/j.ajp.20220802.14
DO  - 10.11648/j.ajp.20220802.14
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 70
EP  - 76
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20220802.14
AB  - In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of improvement strategies aimed at reducing hospital acquired pressure injury and decannulations. During this two-year time 150 nursing surveys and comprehensive literature reviews were completed to identify best practices and essential learning needs of the staff. The outcomes of these reviews helped to create improvement strategies which included developing educational initiatives focused on to support specific pathophysiologic issues impacting morbidity of patients leading to the quality metric goals. Upon completion of the educational and training initiatives led by the specialty care team, the incidence in tracheostomy decannulations and pressure injuries reduced significantly. Conclusions from this work highlight the importance of frontline staff as pivotal leaders in process change management and quality improvement changes. The teamwork among the interdisciplinary members allowed for enhanced collaboration in improving patient care outcomes and remains an active forum for evaluation of improvement in patient care. The efforts of the specialty care team provided sufficient data to support the implementation of specialty care teams that align efforts with that of organizational goals and aimed at reducing patient harm.
VL  - 8
IS  - 2
ER  -

Copy | Download