Standardised and Safe Intubation Package (SSIP)

Initiative Type
Redesign
Service Improvement
Status
Deliver
Added
27 June 2019
Last updated
14 August 2019

Summary

The Standardised and Safe Intubation Package (SSIP) provides a standardised, safe approach to patient intubation in Emergency Departments (EDs) that can be replicated in most Queensland Health facilities.  SSIP aims to assist in reducing cognitive load on treating clinicians and increasing team work and communication.  SSIP empowers staff in facilities to ‘own’ the intubation process and to assist doctors if required.

SSIP is derived from longstanding practices safely used in the retrieval setting and in tertiary EDs.

Key dates
Jul 2019
Jun 2020
Partnerships
Queensland Emergency Department Strategic Advisory Panel (QEDSAP)

Aim

By providing a standardised safe approach to patient intubation in EDs, SSIP aims to assist in reducing cognitive load on treating clinicians and increasing team work and communication.

Benefits

  • Standardisation of approach for intubation.
  • Shared Mental Model leading to decreased cognitive load.
  • Reduction in adverse events.
  • Increased confidence in the process of intubation.

Background

The SSIP Initiative lead is Dr Jacob O’Gorman, FACEM Staff Specialist, Gladstone Hospital. Central Queensland HHS.

Despite improvements in many metropolitan EDs and retrieval services increasing safety of intubation with use of standardised equipment, drugs, process and checklists, there appears to be scope to introduce similar improvements to other sites including regional and rural hospitals.

While not exclusively targeting smaller sites, the SSIP initiative particularly lends itself to rural and regional departments which face the additional challenges of:

  • medical staff with varying levels of experience with the intubation process (including a reliance on locum doctors and General Practitioners).
  • lack of medical staff, resulting in doctors having to perform multiple roles (such as team leader and airway doctor) whist simultaneously resuscitating a patient and also directing the set-up for intubation.

Solutions Implemented

The standardised and safe intubation package consist of:

  1. An airway shadow-board.
  2. Pre- and post-intubation checklists.
  3. Recipe cards for drug draw-up.
  4. Education and training.
  5. Customised airway trolley (optional).

Evaluation and Results

There has been overwhelming support and positive feedback for the ‘airway package’ after its implementation in Gladstone hospital. Both medical and nursing staff report marked improvements in patient care, reduced adverse events and increased confidence with reduced stress involved in the process of intubation.

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Key contact

Jacob O’Gorman
FACEM Staff Specialist and Initiative Lead, Gladstone Hospital.
PROV-ED Project – Healthcare Improvement Unit (HIU) – Clinical Excellence Queensland (CEQ)
(07) 3646 5005
PROVED.Project@health.qld.gov.au