Standardised and Safe Intubation Package (SSIP)

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Initiative Type

Redesign

Service Improvement

Status

Deliver

Added

27 June 2019

Last updated

04 January 2024

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.

Derived from longstanding practices safely used in the retrieval setting and in tertiary EDs, it consists of customisable resources including:
•   Equipment Shadow Board
•   Drug Draw-up Guide
•   Pre- and Post-implementation Checklists
•   User Guide

SSIP provides valuable clinical resources for a high acuity, but often infrequent procedure.

Key dates

Jul 2019

Implementation sites

All Queensland Health Emergency Departments and rural and remote facilities

Partnerships

Queensland Emergency Department Strategic Advisory Panel (QEDSAP); QH Rural and Remote Clinical Support Unit; Retrieval Services Queensland

Aim

By providing a standardised safe approach to patient intubation in EDs, SSIP aims to increase patient safety by 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.
improved patient safety

Background

ED Staff Specialist Dr Jacob O’Gorman, introduced and intubation package to Gladstone Hospital ED, having used similar resources in the retrieval setting.

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 while simultaneously resuscitating a patient and directing the set-up for intubation.
the intubation package was adopted and further developed by PROV-ED to be offered to facilities across the state.

Solutions Implemented

SSIP resources have been included in the Queensland Rural and Remote Emergency Services Standardisation (RRESS) Guidelines Airway Procedural Kit and distributed to more than 150 rural and remote facilities.
The PROV-ED team has worked with larger facilities to customise the resources for implementation and SSIP has attracted significant interest from outside Queensland Health.

Evaluation and Results

Overwhelming support and positive feedback for the ‘airway package’ after its implementation in Gladstone Hospital included both medical and nursing staff reporting marked improvements in patient care, reduced adverse events and increased confidence with reduced stress during the intubation process.

Under PROV-ED, in addition to inclusion in the RRESS guidelines, customised resources are in use at about 20 other Queensland Health EDs, and external interest has led to adoption in several Queensland Health ICUs, private hospitals, interstate remote facilities (Christmas Island, Cocos & Keeling Islands) and a disaster management NGO.

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