NDLI: Quality improvement interventions to prevent unplanned extubations in pediatric critical care: a systematic review

Content Provider	Springer Nature : BioMed Central
Author	Wollny, Krista Cui, Sara McNeil, Deborah Benzies, Karen Parsons, Simon J. Sajobi, Tolulope Metcalfe, Amy
Abstract	Background An unplanned extubation is the uncontrolled and accidental removal of a breathing tube and is an important quality indicator in pediatric critical care. The objective of this review was to comprehensively synthesize literature published on quality improvement (QI) practices implemented to reduce the rate of unplanned extubations in critically ill children. Methods We included original, primary research on quality improvement interventions to reduce the rate of unplanned extubations in pediatric critical care. A search was conducted in MEDLINE (Ovid), Embase, and CINAHL from inception through April 29, 2021. Two reviewers independently screened citations in duplicate using pre-determined eligibility criteria. Data from included studies were abstracted using a tool created by the authors, and QI interventions were categorized using the Behavior Change Wheel. Vote counting based on the direct of effect was used to describe the effectiveness of quality improvement interventions. Study quality was assessed using the Quality Improvement Minimum Quality Criteria Set (QI-MQCS). Results were presented as descriptive statistics and narrative syntheses. Results Thirteen studies were included in the final review. Eleven described primary QI projects; two were sustainability studies that followed up on previously described QI interventions. Under half of the included studies were rated as high-quality. The median number of QI interventions described by each study was 5 [IQR 4–5], with a focus on guidelines, environmental restructuring, education, training, and communication. Ten studies reported decreased unplanned extubation rates after the QI intervention; of these, seven had statistically significant reductions. Both sustainability studies observed increased rates that were not statistically significant. Conclusions This review provides a comprehensive synthesis of QI interventions to reduce unplanned extubation. With only half the studies achieving a high-quality rating, there is room for improvement when conducting and reporting research in this area. Findings from this review can be used to support clinical recommendations to prevent unplanned extubations, and support patient safety in pediatric critical care. Systematic review registration This review was registered on PROSPERO (CRD42021252233) prior to data extraction.
Related Links	https://systematicreviewsjournal.biomedcentral.com/counter/pdf/10.1186/s13643-022-02119-8.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	20464053
DOI	10.1186/s13643-022-02119-8
Journal	Systematic Reviews
Issue Number	1
Volume Number	11
Language	English
Publisher	BioMed Central
Publisher Date	2022-12-02
Access Restriction	Open
Subject Keyword	Medicine Public Health Biomedicine Statistics for Life Sciences Health Sciences Intensive care units Pediatric Patient safety Systematic review Extubation Quality improvement Critical care Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Medicine
Journal Impact Factor	6.3/2023
5-Year Journal Impact Factor	4.5/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Reducing Unplanned Extubations in the Pediatric ICU: Are We Seeing the Whole Picture?

Reducing Unplanned Extubations in the Pediatric ICU: Are We Seeing the Whole Picture?--Reply.

Plan to Have No Unplanned: A Collaborative, Hospital-Based Quality-Improvement Project to Reduce the Rate of Unplanned Extubations in the Pediatric ICU.

Clinical Study Reducing Unplanned Extubations in a Pediatric Intensive Care Unit: A Systematic Approach (2009)

Multidisciplinary interventions and continuous quality improvement to reduce unplanned extubation in adult intensive care units

Predicting Reintubation After Unplanned Extubations in Children: Art or Science?

Telemedicine with clinical decision support for critical care: a systematic review

Experiences of a Regional Quality Improvement Collaborative to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit

A prospective observational quality improvement study of the sustained effects of a program to reduce unplanned extubations in a pediatric intensive care unit.

Quality improvement interventions to prevent unplanned extubations in pediatric critical care: a systematic review

Similar Documents

Reducing Unplanned Extubations in the Pediatric ICU: Are We Seeing the Whole Picture?

Reducing Unplanned Extubations in the Pediatric ICU: Are We Seeing the Whole Picture?--Reply.

Plan to Have No Unplanned: A Collaborative, Hospital-Based Quality-Improvement Project to Reduce the Rate of Unplanned Extubations in the Pediatric ICU.

Clinical Study Reducing Unplanned Extubations in a Pediatric Intensive Care Unit: A Systematic Approach (2009)

Multidisciplinary interventions and continuous quality improvement to reduce unplanned extubation in adult intensive care units

Predicting Reintubation After Unplanned Extubations in Children: Art or Science?

Telemedicine with clinical decision support for critical care: a systematic review

Experiences of a Regional Quality Improvement Collaborative to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit

A prospective observational quality improvement study of the sustained effects of a program to reduce unplanned extubations in a pediatric intensive care unit.

Quality improvement interventions to prevent unplanned extubations in pediatric critical care: a systematic review