Photo Credit: Sergeyryzhov

The following is a summary of “Pediatric Ventilator-Associated Events Before and After a Multicenter Quality Improvement Initiative,” published in the December 2023 issue of Critical Care Medicine by Wu et al. 

For a study, researchers aimed to evaluate if following certain practices in a quality improvement plan could reduce pediatric ventilator-associated events (PedVAE) rates. The multicenter study spanned 2017 to 2020, involving ventilated patients in neonatal, pediatric, and cardiac ICUs across 95 hospitals in North America. Data analysis was conducted between September 2021 and April 2023 to determine the impact of these interventions.

Among the 95 hospitals in the SPS network, 21 were in the Pioneer cohort, and 74 were in the non-Pioneer cohort. Reliable data were reported by 12 hospitals (57%) in the Pioneer group and 33 (45%) in the non-Pioneer group. In the 12 reliable hospitals, there was a decrease in PedVAE rate from 1.9 to 1.4 events per 1000 ventilator days (absolute rate difference, −0.6; 95% CI, −0.5 to −0.7; P < .001). However, the PedVAE rate did not significantly change among the 33 hospitals that reliably reported PedVAE rates but didn’t implement the bundle. Notably, 3 of the 12 hospitals that regularly discussed extubation readiness saw a drop in PedVAE rate from 2.6 to 1.2 events per 1000 ventilator days (absolute rate difference, −1.4; 95% CI, −1.0 to −1.7; P < .001), unlike the other 9 hospitals that did not have this discussion and didn’t show a decrease.

Researchers discovered that implementing a quality improvement intervention across multiple hospital ICUs led to a significant decrease in the rate of PedVAEs. Their findings indicate that daily discussions about extubation readiness during morning rounds could be a valuable strategy for ICU teams aiming to lower PedVAE rates.

Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2812623