ResidentAbstracts

UHC/AACN Nurse Residency Program

2016 NRP Annual Meeting - Call for Abstracts
Organization: University Medical Center of El Paso
Nurse residency coordinator name(s) and email (s): Julie Gest JGest@umcelpaso.org
Anticipated number of nurse residents approved for travel by your organization: Two
Project/presentation title: Take a Deep Breath Rethinking Endotracheal Intubation
Organization name: Airway Aces
Nurse resident(s)/project participant(s):
Patrick Reed

preed@umcelpaso.org

(Name)

(E-mail)

Crystal Molina

crystalmolina@umcelpaso.org

(Name)

(E-mail)

Learning objectives (list 2-3): for purpose of evaluating for podium presentation

Recognize, identify, and prevent major complications secondary

endotracheal tube (ETT) placement.

Elevate nursing knowledge of airway management, medications,

positioning, and foundational interventions pre/intra/post-procedural insertion of a
definitive airway.

Identify measures for collaboration with providers and allied health

professionals in the management of the intubated ventilator patient.

Abstract narrative (300 words or less):

Registered nurses (RN) are charged with the ultimate legal responsibility for the safety and care
of their assigned patients. This duty to act does not end at the head of the bed during
endotracheal tube (ETT) insertion; it begins. In no small part due to the traditional role of
medical practitioners, duties of respiratory care professionals, and the historical limited state
scopes of practice RNs have deferred taking lead roles in assessment and intervention of patients
during this invasive procedure.
This project aims to provide critical care RNs education on pre and intra-procedural techniques
at preventing aspiration, oxygen desaturation, esophageal intubation, cuff leaks, and accidental
extubation of the ETT as well as updating knowledge and rethinking use of paralytics, sedatives,
and analgesia can avoid disastrous complications. Post-intubation management of intubated
patients boarded in the emergency department (ED) is also a major component of this project to
avoid long-term complications with ventilated patients.
The primary measurable goal is to reduce ventilator-associated pneumonia (VAP) the most
common infection in intensive care units and mitigate complications from improper ETT
placement. To accomplish these goals, the Airway Aces team created a preliminary checklist to
direct a time-out when time permits. This legal document is expected to become part of the
medical record, serve as a performance improvement tool, and be included in both the ED and
Difficulty Airway Team (DART) airway boxes house-wide. This project is expected to roll out
over various disciplines of nursing over the several years with possible future collaboration with
physicians submitting data to the National Emergency Airway Registry III (NEAR) database
through the local site principal investigator. Finally, we hope to provide a new, codified nursing
policy at UMC of El Paso supported with a nursing competency educators can verify and report
the ability of trained nursing staff.

References
Bonten, M. (2011). Ventilator- Associated Pneumonia: Preventing the Inevitable. Invited
Article Healthcare Epidemidology, 52(1), 115-121. doi:10.1093/cid/ciq075
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Harm, F., Zuercher, M., Bassi, M., & Ummenhofer, W. (2013). Prospective observational
study on tracheal tube cuff pressures in emergency patients- is neglecting the problem the
problem? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine,
83(21), 1-6. doi:10.1186/1757-7241-21-83
Jaber, S., Jung, B., Corne, P., Sebbane, M., Muller, L., Chanques, G., . . . Lefrant, J. Y.
(2010). An intervention to decrease complications related to endotracheal intubation in
the intensive care unit: a prospective, multiple-center study. Intensive Care Med, 36(2),
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Sakles, J., Chiu, S., Mosier, J., Walker, C., & Stolz, U. (2013). The Importance of First
Pass Success When Performing Orotrachial Intubation in the Emergency Department.
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