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Code Critical Airway Teams Improves Patient Safety
March 2014, Vol 145, No. 3_MeetingAbstracts Critical Care | March 2014
Code Critical Airway Teams Improves Patient Safety Emily Rhoades, APRN-BC; Pat McCabe, RN; Kristen Nelson, APRN-BC; Ziad Deeb, MD; Jeffrey Dubin, MD; George Sample, MD Medstar Washington Hospital Center, Washington, DC
Chest. 2014;145(3_MeetingAbstracts):186A. doi:10.1378/chest.1782484
Abstract SESSION TITLE: Critical Care Posters III SESSION TYPE: Poster Presentations PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM PURPOSE: It takes an experienced multi-professional team to handle emergent airway situations. Critical airway emergencies are increasing due to advances in medical treatments, obesity and sleep apnea. Difficult airway events are low volume and high risk, requiring expert skill and communication. In the United States, a leading adverse patient safety event is “death or serious disability associated with airway management." We created a Code Critical Airway Team to manage airway emergencies. METHODS: Utilizing a complex framework with the goal of successful airway management in an urban level-one trauma center, the project was divided into six components. These components were patient safety, patient assessment, teamwork, performance improvement, equipment and team simulation training. The goals of the patient safety component were to provide a patient-centered, least invasive approach to airway management while maintaining airway stability. An identified issue was the reactive use of the “Surgical” Airway Team for patients with a difficult airway. The interventions for this component were developing proactive triggers for calling the team, and changing the name to a "Critical" Airway Team to deemphasize the surgical aspect. Hospital wide airway management education was implemented. An additional emphasis on education in the Emergency Department also occurred during the course of this project.
RESULTS: The number of code critical airway calls increased over the last three years while the percentage of surgical airways decreased since before the project was initiated. We saw an increase in respiratory distress calls over respiratory arrest calls, reinforcing the benefit of a proactive approach. Code airway re-education in the Emergency Department resulted in a statistically significant increase in the number of calls there. As a by-product of this process, reliability of available appropriate airway equipment is now 100%. CONCLUSIONS: This project made significant process improvements in the areas of patient safety, team communication, and equipment availability. CLINICAL IMPLICATIONS: Hospitals should develop a specialized airway team to decrease adverse airway events. DISCLOSURE: The following authors have nothing to disclose: Emily Rhoades, Pat McCabe, Kristen Nelson, Ziad Deeb, Jeffrey Dubin, George Sample No Product/Research Disclosure Information
Code Critical Airway Teams Improves Patient Safety Emily Rhoades, APRN-BC; Pat McCabe, RN; Kristen Nelson, APRN-BC; Ziad Deeb, MD; Jeffrey Dubin, MD; George Sample, MD Medstar Washington Hospital Center, Washington, DC
Chest. 2014;145(3_MeetingAbstracts):186A. doi:10.1378/chest.1782484
Abstract SESSION TITLE: Critical Care Posters III SESSION TYPE: Poster Presentations PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM PURPOSE: It takes an experienced multi-professional team to handle emergent airway situations. Critical airway emergencies are increasing due to advances in medical treatments, obesity and sleep apnea. Difficult airway events are low volume and high risk, requiring expert skill and communication. In the United States, a leading adverse patient safety event is “death or serious disability associated with airway management." We created a Code Critical Airway Team to manage airway emergencies. METHODS: Utilizing a complex framework with the goal of successful airway management in an urban level-one trauma center, the project was divided into six components. These components were patient safety, patient assessment, teamwork, performance improvement, equipment and team simulation training. The goals of the patient safety component were to provide a patient-centered, least invasive approach to airway management while maintaining airway stability. An identified issue was the reactive use of the “Surgical” Airway Team for patients with a difficult airway. The interventions for this component were developing proactive triggers for calling the team, and changing the name to a "Critical" Airway Team to deemphasize the surgical aspect. Hospital wide airway management education was implemented. An additional emphasis on education in the Emergency Department also occurred during the course of this project.
RESULTS: The number of code critical airway calls increased over the last three years while the percentage of surgical airways decreased since before the project was initiated. We saw an increase in respiratory distress calls over respiratory arrest calls, reinforcing the benefit of a proactive approach. Code airway re-education in the Emergency Department resulted in a statistically significant increase in the number of calls there. As a by-product of this process, reliability of available appropriate airway equipment is now 100%. CONCLUSIONS: This project made significant process improvements in the areas of patient safety, team communication, and equipment availability. CLINICAL IMPLICATIONS: Hospitals should develop a specialized airway team to decrease adverse airway events. DISCLOSURE: The following authors have nothing to disclose: Emily Rhoades, Pat McCabe, Kristen Nelson, Ziad Deeb, Jeffrey Dubin, George Sample No Product/Research Disclosure Information