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Assessment of an Unplanned Extubation Bundle to Reduce Unplanned Extubations in Critically Ill Neonates, Infants, and Children

PIPSQC is pleased to share the recent publication in JAMA Pediatrics, entitled "Assessment of an Unplanned Extubation Bundle to Reduce Unplanned Extubations in Critically Ill Neonates, Infants, and Children."

The publication is available online at:
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2764080

KEY POINTS:

Question:
Is the implementation of an unplanned extubation (UE) bundle, as part of a national quality improvement initiative, associated with a reduction in UEs in critically ill neonates, infants, and children?

Findings:
In this quality improvement study of neonates, infants, and children from 43 participating children's hospitals, use of the UE bundle was associated with a 24.1% reduction in UEs. Importantly, there was also a 36.6% reduction in cardiovascular collapse associated with UE's across the cohort.

Meaning:
A widespread quality improvement initiative with bundle implementation led to a meaningful and sustained reduction in pediatric UEs and morbidity associated with these events.