title: A multifaceted quality improvement program improves endotracheal tube confirmation documentation in the emergency department.
abstract: Confirmation of endotracheal tube (ETT) position is an essential part of emergency department (ED) airway care. The study team evaluated the effect of a multifaceted quality improvement initiative on improving confirmation documentation rates. Rates of documentation of appropriate methods of ETT position confirmation were better for patients undergoing ETT placement in the study site ED than for those arriving already intubated (103/127 [81.1%] vs 19/71 [26.8%]; relative risk [RR] = 3.03; 95% confidence interval [CI] = 2.04 to 4.49). Overall rates of documentation of appropriate methods of ETT position confirmation were higher after the intervention (557/758 [73.5%] vs 122/198 [61.6%]; RR = 1.19; 95% CI = 1.06 to 1.34), with a greater increase among the group presenting to the ED with an ETT already placed (116/259 [44.8%] vs 19/71 [26.8%]; RR = 1.67; 95% CI = 1.11 to 2.51) compared with those intubated in the study site ED (103/127 [81.1%] vs 441/499 [88.4%]; RR = 0.92; 95% CI = 0.8389 to 1.0039).
authors.affiliation: Cleveland Clinic, Cleveland, OH phelanm@ccf.org.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Phelan
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: Fredric M
authors.initials: FM
authors.lastname: Hustey
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Glauser
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: James
authors.initials: J
authors.lastname: Bena
mesh_terms: D004282:Documentation / Q000379:methods* / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D005246:Feedback; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods* / Q000592:standards*; D008297:Male; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards
keywords: airway; confirmation; documentation; emergency