iNICQ 2012 Controversies in Respiratory Care

Session 1: January 31, 2012, Controversies in Oxygen Management 90 min
VON Day 1: Oxygen Targeting (existing audit with new serial measurement option)
Oxygen Targeting VON Day Audit review and summary

Potentially Better Practices:

• Obtain a pulse oximetry reading by two minutes of life and continuously monitor the heart rate and oxygen saturation during resuscitation.
• Initiate resuscitation with a fraction of inspired oxygen (FiO2) less than 1.0 and titrate FiO2 to maintain oxygen saturation in the desired range.
• Minimize use of supplemental O2 by titrating according to target SpO2.

QI Theme: Measurement
Questions and Discussion
Summary
Team Exercise

iNICQ Intensive Web Session 1: February 15, 2012, Controversies in Oxygen Management 60 min Themes in depth: Measurement
Improvement Story (Oxygen)
Team huddle
Discussion and faculty commentary
Summary
Team Exercise

Session 2: March 7, 2012, Controversies in Delivery Room and Golden Hour Care 90 minutes
VON Day 2: Delivery Room Checklist
DR Checklist VON Day Audit review and summary

Potentially Better Practices:

• Improve teamwork and communication in the delivery room using simulations, briefings, debriefings, and team training.
• Utilize a team approach to respiratory care during the Golden Hour among VLBW infants.
• Maintain normal temperature in very-low-birth-weight (VLBW) infants.

QI Theme: Family Centered Care
Questions and Discussion
Summary
Team Exercise

iNICQ Intensive Web Session 2: April 11, 2012, Delivery Room and Golden Hour Care 60 minutes
Themes in depth: Family Centered Care
Improvement Story (DR Golden Hour)
Team huddle
Discussion and faculty commentary
Summary
Team Exercise

Session 3: May 16, 2012, Minimizing Intubation 90 min
VON Day 3: Intubation and Extubation Audit
Intubation and Extubation Audit review and summary

Potentially Better Practices:

• Promote nasal CPAP for initial stabilization in selected infants.
• Reduce unplanned extubations by monitoring their frequency and identifying and eliminating their causes.
• Minimize the duration of mechanical ventilation by promoting early extubation.

QI Theme: Reliability
Questions and Discussion
Team Exercise

iNICQ Intensive Web Session 3: June 13, 2012, Intubation and Extubation 60 min
Themes in depth: Reliability
Improvement Story (FCC)
Team huddle
Discussion and Faculty Commentary
Summary
Team Exercise

Session 4: July 18, 2012, Reducing the Risk for CLD 90 min
VON Day 4: Respiratory care audit
Ventilator Management Audit review and summary

Potentially Better Practices:

• Administer surfactant as soon as possible after birth for eligible infants.
• Administer Vitamin A to infants at risk for chronic lung disease.
• Incorporate gentle ventilation techniques for mechanically ventilated infants.
• Administer caffeine to infants for apnea of prematurity.

QI Themes review
Questions and Faculty Commentary
Summary
Team Exercise

iNICQ Intensive Web Session 4: August 15, 2012, Assisted Ventilation 60 min
Welcome and Introduction
Themes in depth:
Improvement Story
Faculty Commentary
Discussion
Improvement Story
Faculty Commentary
Discussion
Summary
Team Exercise

Session 5: September 19, 2012, Preventing ventilator complications 90 min
VON Day 5: Ventilator Complications and Safety
Case Presentation or Clinical Question
Ventilator Complications Audit review and summary

Potentially Better Practices:

• Define and limit Ventilator Associated Pneumonia (VAP).
• Define and limit other ventilator associated complications.

Questions and Faculty Commentary
Enhancing QI Performance
Summary
Team Exercise

iNICQ Intensive at Annual Meeting: Ventilator Associated Complications 60 min
Joint Plenary with NICQ 7 on October 12, 2012 in Chicago, IL
Ventilator Associated Complications
Reliability and Safety
Improvement Story

October 12, 2012 Improvement Stories by iNICQ Teams at Annual Quality Congress
Multidisciplinary teams from the iNICQ Internet Collaborative will have the opportunity to present their improvement stories in Washington, DC in conjunction with the Vermont Oxford Network Annual Meeting and Quality Congress. Intensive Track members will have the opportunity to attend the NICQ 7 face-to-face meeting and half day iNICQ workshop on Friday October 12, 2012, preceding the VON Annual Meeting and Quality Congress.

Prior to each session teams will participate in a VON Day to assist them in preparing for the session.

Teams will be asked to schedule an additional 30 minutes to work together on a structured group exercise following the formal session. The goal will be for teams to identify opportunities for improving the quality and safety of care and to create an action plan for improvement.