Semester

Summer

Date of Graduation

2024

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Committee Chair

Kellon Smith

Committee Member

Michael Peterson

Abstract

Problem Statement: In 2022, the first-attempt endotracheal intubation success rate of an aeromedical agency had steadily declined and was currently below the international average of 88.48%. This decreased success rate potentially placed patients at risk for adverse events that increase morbidity and mortality. Background: Patients who experience a failed first-attempt intubation are at greater risk of intubation related complications. These complications include hypoxemia episodes, severe arrhythmias, pulmonary aspiration, hypotension episodes, cardiac arrest, and death. Literature Review: Preoxygenation, patient positioning, maintenance of oxygenation, drug selection, and device utilization have been found to increase first-attempt endotracheal success rates. Project Aims: The project aim was to increase the first-attempt intubation success rates of the HealthNet Base 1 (Morgantown) and Base 6 (Buckhannon) clinicians to 90% or above within six months. Methods: Implementation of an educational program that emphasized the utilization of preoxygenation, patient positioning, maintenance of oxygenation, drug selection, and device utilization. Intervention: A pilot educational program was conducted on December 6, 2022, during the quarterly critical care transport training of HealthNet Base 1 and Base 6. Participants completed a five-point Likert-scale survey prior to and immediately following the educational program to evaluate learning and intent to implement the proposed practice changes. Plan for Evaluation: Evaluation was conducted by an electronic patient chart audit that was completed approximately seven months after the educational program. Results: First-attempt intubation success rates increased by 2.3% in the pilot study group. Conclusions: Completing an evidenced based advanced airway course may increase first attempt intubation success.

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