Utilizing an Intensive Training Program to Improve Neonatal-pediatric Transport Intubation Success

Purpose/Objectives: Our goal was to increase the intubation success rates and decrease the number of intubation attempts for the Neonatal-Pediatric Transport team through an intensive, one on one training program that consisted of a video lecture, simulation, and supervised learning.

Design/Methods: This on-going quality improvement project began on January 1, 2021 with an initial baseline survey of the Neonatal-Pediatric Transport team members regarding their past intubation experiences and comfort performing the procedure in different environments. Over a two-month period all members of the transport team were asked to sequentially watch an intubation procedure video lecture and review a validated neonatal intubation procedural competency checklist. Following this initial didactic phase, the team engaged in a simulation experience where they intubated both a pre-term and term mannequin utilizing the intubation procedural competency checklist. The simulated intubations occurred under the supervision of an attending neonatologist. All simulations were video recorded for future one on one review with the staff neonatologist. Subsequent in-house intubations performed by the transport team were observed and evaluated by a supervising staff neonatologist who provided real-time feedback to the transport team member following the procedure. Intubations performed by the transport team were compiled from January 1, 2020 until July 1, 2021. Primary outcomes were the number attempts per intubation and if the intubation was ultimately successful.

Results: During the 2020 calendar year, the Transport team successfully performed 20 intubations out of 30 patients (67% successful placement of endotracheal tube) with a median number of 2 attempts per successful intubation. Initial review of the first 4 months following the completion of the one-one training (March 1, 2021 through June 30, 2021) found that the transport team successfully performed 11 out of 13 intubations (85% successful placement of endotracheal tube) with a median number of 1 attempt per successful intubation.

Conclusion/Discussion: The implementation of an intensive one on one intubation training program for our Neonatal-Pediatric Transport team has improved intubation success rates and decreased the number of attempts required per successful intubation compared with procedural success data from the previous year. Follow-up team member surveys regarding experiences, comfort performing intubations following the training program will be distributed in the upcoming months to further refine the next steps of the training program and address any barriers to success . Continued surveillance is required to evaluate whether improvements in successful intubation can be sustained over time .