1. How traditional and digital analytics interventions can enhance lung-protective ventilation strategies during general anaesthesia: A two-year quality improvement project analysis
- Author
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Cléa Gandon, Yann Gricourt, Maxime Thomas, Benjamin Garnaud, Mona Elhaj, Christophe Boisson, Thierry Boudemaghe, Samir Jaber, Pierre Géraud Claret, Philippe Cuvillon, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and MORNET, Dominique
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[SDV.IB] Life Sciences [q-bio]/Bioengineering ,[SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,General Medicine ,Anesthesia, General ,Critical Care and Intensive Care Medicine ,Quality Improvement ,Respiration, Artificial ,Anesthesiology and Pain Medicine ,[INFO.INFO-AU]Computer Science [cs]/Automatic Control Engineering ,Tidal Volume ,[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Humans ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Lung ,[INFO.INFO-AU] Computer Science [cs]/Automatic Control Engineering - Abstract
International audience; Purpose: This quality improvement project evaluated interventions implemented to enhance individual adherence to a lung-protective ventilation strategy and its triad: low tidal volume, PEEP ≥ 5, recruitment manoeuvres.Methods For two years, nine anaesthesia workstations were connected to an automated cloud-based analytics software tool, which automatically recorded ventilation parameters as soon as a new patient case was opened. Four quality improvement periods were determined over the first year: baseline, intervention, no intervention, intervention + digital. In the second year, the digital strategy was continued for nine months, followed by a final “overtime” period. Baseline and no intervention periods included no training. The intervention period included both conventional and educational programs. The digital period included pop-up messages, which automatically appeared on the screen of the anaesthesia data management system when patients were intubated. The primary endpoint was provider adherence to the recommended triad.Results: From October 2018 to December 2020, 12,883 procedures were performed. Data were available for 8968 procedures: baseline (n = 2361), intervention (n = 2423), no intervention (n = 1064), intervention + digital (n = 1862), overtime (n = 1258). Age, Predicted Body Weight, ASA score, type of surgery and airway management were similar between periods. At baseline, 75.2% of procedures reported low tidal volume but only 6.9% involved the complete triad. At over time, Triad was 22% (p
- Published
- 2022
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