Author ORCID Identifier
Semester
Summer
Date of Graduation
2026
Document Type
Problem/Project Report
Degree Type
DNP
College
School of Nursing
Department
Anesthesiology
Committee Chair
Patricia Maramba
Committee Member
Justin Browning
Committee Member
Mike Frame
Abstract
ABSTRACT
Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.
Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.
Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of a PowerPoint presentation, charting reminders, and manometers provided for practice and use. AG Cuffill reference materials were placed in a folder at the base for quick reference. The objectives were to deliver ETT CP training to at least 70% of full-time flight crew during a scheduled base meeting and to improve electronic medical record documentation of initial ETT CPs to greater than 50% compliance within three months post-training through the use of reminders and regular audits.
Methods: Using the PDSA (plan, do, study, act) model, the process involved three one-week cycles, with adjustments made during the first and second cycles: first, delivering a targeted message to reinforce training; second, boosting morale with energy drinks at the base; third, no further changes were needed, and the process was maintained.
Results: Following the intervention, 79.5% of transports had initial CPs documented. There was a significant difference in the proportion of documented initial CPs from pre- to post-intervention (p < 0.05).
Conclusion: Implementing a focused educational initiative led to a substantial increase in ETT CP documentation and safer CP management. Continued use of manometers, regular training, and documentation reinforcement are recommended to maintain compliance and improve airway safety during transport.
Recommended Citation
Noss, Matthew D., "Increasing Documentation of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative for Flight Crew Providers" (2026). Graduate Theses, Dissertations, and Problem Reports (ETD). 13377.
https://researchrepository.wvu.edu/etd/13377
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