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G14 Quality improvement of peak inspiratory and end expiratory pressure settings during infant resuscitation at birth

Authors: V Lander; Andrew L. Skinner; Andrew Clark; FC Brokke; G Ramadan;

G14 Quality improvement of peak inspiratory and end expiratory pressure settings during infant resuscitation at birth

Abstract

Aims In-situ simulation training indicated the need for accurate setup of peak inspiratory pressure (PIP) and positive end expiratory pressure (PEEP) prior to newborn resuscitation. Our project aimed to improve the quality of team learning from latent inaccuracies in PIP and PEEP settings, to reduce harm and improve outcomes for newborn infants through a series of targeted interventions. Methods During 2016, we have undertaken a quality improvement project to measure baseline set-up of resuscitaires in the delivery suite and post-natal wards. The first pdsa (plan do study act) cycle was performed through a prospective daily check of all resuscitaires (n=12) PIP and PEEP settings over a one week period. When issues were identified, an ‘on the spot’ one to one simulation training of midwifery staff was performed. During the second pdsa cycle we introduced ‘resuscitaire flashcards’ to support all team’s learning and to be used as aid memoire for the daily safety checklist on delivery suite. Results During the first pdsa cycle, 10% of the resuscitaires PIP was high (>30 cm H2O) and PEEP was set incorrectly in 48% of the cases. Inaccuracies in PEEP were either too high flow settings (>5 cm H2O) in 22% of cases or too low flow settings ( Conclusion Targeted quality improvement interventions through simulation have improved PIP and PEEP resuscitaires settings. This led to a reduction in latent errors and improved the care given to newborns requiring resuscitation at birth.

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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Average
Average
Average
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