Presenter Status
Fellow
Abstract Type
QI
Primary Mentor
Chris Nitkin MD
Start Date
13-5-2025 11:30 AM
End Date
13-5-2025 1:30 PM
Presentation Type
Poster Presentation
Description
Background: Decrease time to begin iNO weaning from 13 hours to 9.75 hours by 31 December 2024 in patients with persistent pulmonary hypertension of the newborn (PPHN).
Methods: Countermeasures include (1) provider education at each disciplinary level, (2) badge reminder cards and laminated copies of the protocol available at the bedside, (3) order set modifications, (4) abnormality tracking at huddles. Data collection will be automated through weekly Business Objects report. The main outcome measure will be time to first wean of iNO after meeting protocol criteria. Feedback regarding the ease of weaning will be generated via Gemba Rounds.
Results: These interventions led to a decrease in time to first wean of iNO in babies with PPHN to 6.74 hours, a decrease by 52%. Five babies were excluded due to early weaning, four babies were excluded due to need for ECMO, and six babies expired prior to wean.
Conclusions: Implementation of a weaning protocol for iNO leads to decreased time to first wean. However, there is still more education to be done regarding early weaning. The final PDSA cycle will be abnormality tracking at huddles to be done starting 2025.
Included in
Cardiovascular Diseases Commons, Higher Education and Teaching Commons, Medical Education Commons, Pediatrics Commons, Respiratory Tract Diseases Commons, Science and Mathematics Education Commons
Implementation of a weaning protocol for inhaled nitric oxide in a level IV neonatal intensive care unit
Background: Decrease time to begin iNO weaning from 13 hours to 9.75 hours by 31 December 2024 in patients with persistent pulmonary hypertension of the newborn (PPHN).
Methods: Countermeasures include (1) provider education at each disciplinary level, (2) badge reminder cards and laminated copies of the protocol available at the bedside, (3) order set modifications, (4) abnormality tracking at huddles. Data collection will be automated through weekly Business Objects report. The main outcome measure will be time to first wean of iNO after meeting protocol criteria. Feedback regarding the ease of weaning will be generated via Gemba Rounds.
Results: These interventions led to a decrease in time to first wean of iNO in babies with PPHN to 6.74 hours, a decrease by 52%. Five babies were excluded due to early weaning, four babies were excluded due to need for ECMO, and six babies expired prior to wean.
Conclusions: Implementation of a weaning protocol for iNO leads to decreased time to first wean. However, there is still more education to be done regarding early weaning. The final PDSA cycle will be abnormality tracking at huddles to be done starting 2025.
