Quality Improvement Through Covid-19 Intubation Checklist Implementation

Abstract

Purpose: The purpose of this project was to increase awareness and airway provider confidence levels with use of a COVID-19 adult intubation checklist at a rural medical facility in northern Arizona. Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus responsible for COVID-19, has infected over 1.9 million people within the state of Arizona. Some of these COVID-19 patients will develop acute respiratory failure with profound hypoxemia, multi-organ failure, and often may require intubation with invasive mechanical ventilation needs. Airway management of COVID-19 patients may be improved through use of a facility-specific COVID-19 adult intubation checklist. New strategies are needed to decrease the transmission of COVID-19, thus educating airway providers on current recommended checklist use may be critical for providers, healthcare workers, medical organizations, and the surrounding communities. Methods: Through an educational presentation, the recommendations, benefits, and potential for quality improvements with utilization of a COVID-19 adult intubation checklist was presented to project participants. Surveys were conducted before and after the presentation. The survey information was used to identify increases in checklist awareness, airway provider confidence levels, and future intent to use a specialized COVID-19 intubation checklist. Results: Four certified registered nurse anesthetists participated in this project representing a 57% response rate during recruitment. All four participants completed the PowerPoint presentation and both surveys. Survey data displayed reported increases in airway provider confidence levels and likelihood to use a site-specific COVID-19 intubation checklist. 100% (n=4) of participants agreed on improved communication and team performance benefits with use of a properly implemented checklist. Conclusions: Through creating awareness of the current recommendations for intubation of COVID-19 patients, airway provider confidence levels can be increased with utilization of a site-specific intubation checklist.