Improving First-Attempt Intubation Success Rate in a Level IV Neonatal Intensive Care Unit Through the Use of a Video Laryngoscope: A Quality Improvement Initiative

Stephanie Martinez; Monika Bhola; Nori Mercuri Minich; Charlene Nauman; Kathleen Deakins; Allison Oliverio; Gulgun Yalcinkaya

doi:10.1055/a-2533-2465

American Journal of Perinatology, Table of Contents

Am J Perinatol 2025; 42(13): 1743-1753
DOI: 10.1055/a-2533-2465

Original Article

Improving First-Attempt Intubation Success Rate in a Level IV Neonatal Intensive Care Unit Through the Use of a Video Laryngoscope: A Quality Improvement Initiative

Authors

Stephanie Martinez

¹Division of Neonatology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Cleveland, Ohio

²Division of Neonatology, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
Monika Bhola

¹Division of Neonatology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Cleveland, Ohio

³Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
Nori Mercuri Minich

¹Division of Neonatology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Cleveland, Ohio

³Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
Charlene Nauman

¹Division of Neonatology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Cleveland, Ohio
Kathleen Deakins

¹Division of Neonatology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Cleveland, Ohio
Allison Oliverio

¹Division of Neonatology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Cleveland, Ohio
Gulgun Yalcinkaya

¹Division of Neonatology, University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Cleveland, Ohio

³Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio

Abstract

Objective

There is increasing evidence that the use of a video laryngoscope improves first-attempt intubation rates in neonates. The goal of this quality improvement initiative was to improve the first-attempt intubation success rate from 45 to 65% in 2.5 years through the introduction and increased use of a video laryngoscope in a level IV neonatal intensive care unit (NICU).

Study Design

We utilized the Model for Improvement with plan-do-study-act cycles targeted at increasing buy-in and comfort with the use of a video laryngoscope. Data on 418 intubations were collected from November 2021 to April 2024.

Results

Through increasing routine use of the video laryngoscope, achieved via a staggered introduction of the device, creation of reference materials, and coaching workshops, we improved the overall first-attempt intubation success rate from 45 to 57% during the intervention period.

Conclusion

We increased the first-attempt success rate of intubations in the NICU by effectively implementing the use of a video laryngoscope into daily practice.

Key Points

Neonatal intubations have low success rates, but video laryngoscopy improves success especially for those with less experience.
This study shows that video laryngoscopy adoption in a neonatal ICU improved first-attempt intubation rates.
This study contributes to neonatal intubation and video laryngoscopy literature from a quality improvement perspective.

Keywords

intubation - neonate - video laryngoscope - quality improvement

Full Text

References

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