A pediatric mechanical ventilation educational initiative in two intensive care units

Abstract

Abstract Introduction: Inappropriate ventilator settings, non-adherence to a lung-protective ventilation strategy, and inadequate patient monitoring during mechanical ventilation can potentially expose critically ill children to additional risks. We set out to improve team theoretical knowledge and practical skills regarding pediatric mechanical ventilation and to increase compliance with treatment goals. Methods: An educational initiative was conducted from August 2019 to July 2021 in a neonatal and pediatric intensive care unit of the University Children's Hospital, Hamburg-Eppendorf, Germany. We tested baseline theoretical knowledge using a multiple choice theory test (TT) and practical skills using a practical skill test (PST), consisting of four sequential Objective Structured Clinical Examinations of physicians and nurses. We then implemented an educational bundle that included video self-training, checklists, pocket cards, and reevaluated team performance. Ventilators and monitor settings were randomly checked in all ventilated patients. We used a process control chart and a mixed-effects model to analyze the primary outcome. Results: Staff members took part in 183 theory tests (TT) and 169 practical skill tests (PST). The initiative was associated with a substantial increase in staff TT and PST performance (CI) (TT: 80 [77.2–82.9]% vs. 86 [83.1–88.0]%, PST: 73 [69.7–75.5]% vs. 95 [93.8–97.1]%), self-confidence, and compliance with mechanical ventilation treatment goals (87.8% vs. 94.5%). Discussion: Implementing a pediatric mechanical ventilation education bundle improved theoretical knowledge and practical skills among multi-professional pediatric intensive care staff and increased treatment goal compliance in ventilated children.