Improving Successful Intubations in the Neonatal Intensive Care Unit

Abstract

Background: Neonatal intubation is challenging due to an infant’s size, anatomy, and tolerance to the procedure. Utilizing rapid sequence intubation (RSI) improves outcomes for neonates and decreases adverse events (Johnston et al., 2021; Sing et al., 2022). Local Problem: A level IV NICU does not currently provide RSI prior to intubations and the current first-attempt success rate is 37%. Methods: PDSAs were used to improve first-attempt success rates from 37% to 95%. Following an analysis of a Pareto chart, the team directed their effort toward developing a Rapid Sequence Intubation (RSI) protocol and education for team members. Results: After the creation and implementation of the RSI protocol, first-attempt intubation success improved from 37% to 60%. Following the initiation of additional interventions, the success rate continued to improve. Conclusion: Neonatal RSI is instrumental in improving intubation processes and outcomes.