Neonatal Intubation: Can We Do It Better? A Quality Approach

Over the past two years we have been working diligently on a Neonatal First Pass Intubation Quality approach to improve intubation success within our team. We wanted to understand where we were at the start of the PDSA, how we improve first-pass rates, and what our direction should be. Working closely with our Quality Assurance chair, Education, and Outreach Education we reviewed data across a three-year period to assess performance. Throughout the past three years, we have incorporated Simulation experiences, documentation required intubation of Manikin heads, and new micro preemie manikin, ongoing documented Operating Room practice, a new Neo View intubation instrument, recorded video presentation from our Anesthesia department, and the acquisition of fetal pigs for intubation practice. An integral piece of the PDSA puzzle was the review and buy-in for the intubation medication protocol introduced by our medical center. Our practice was not streamlined for this cohort, and we believed that incorporating a directed approach to medication administration for these infants would improve our practice. We have presented our findings to the team on multiple occasions over the past three years in staff meetings.
Under the guidance of our Neonatal Medical Director, each of our Registered Nurses and Respiratory Therapists that can perform neonatal intubation were included in the training of the Neo View by the Neonatal Medical Director that was purchased for our LISA procedure. All staff were allowed to participate in scenario-based training that incorporated medication administration of the protocol during simulation and medication calculation for further reinforcement.