Transition From an ICU Ventilator to a Portable Home Ventilator in Children.

Background: The transition from an ICU ventilator to a portable home ventilator (PHV) for children requiring long-term mechanical ventilation is a crucial step in preparing for discharge home and may not be successful on the first attempt. A review of this process at our institution revealed that some children required multiple trials before they were able to tolerate a PHV. A protocol was developed to standardize the transition process and reduce the number of failed attempts.

Accuracy of Transcutaneous CO Values Compared With Arterial and Capillary Blood Gases.

Background: Transcutaneous monitors are utilized to monitor a patient's respiratory status. Some patients have similar values when comparing transcutaneous carbon dioxide (P ) values with blood gas analysis, whereas others show extreme variability. A retrospective review of data was performed to determine how accurately P correlated with CO values obtained by arterial blood gas (ABG) or capillary blood gas.

Evaluating Evidence-Based Practice Knowledge and Beliefs Through the e-Learning EBP Academy.

Background: This research examined evidence-based practice (EBP) knowledge and beliefs before and after a 3-month e-learning program was implemented to build EBP capacity at a large children's hospital.

Method: Ten clinicians completed the development, implementation, and evaluation of the e-learning education, comprising phase one. Revision and participation by 41 clinicians followed in phase two.

Implementation of a β-Agonist/Airway Clearance Protocol in a Pediatric ICU.

Background: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist.

Quality Improvement Project to Improve Timeliness Between Bronchodilator Treatments from Emergency Department to Medical Wards.

Background: Quality improvement methodology was applied to study sporadic reports that patients with asthma were not given bronchodilator treatments or assessed within an appropriate time frame when they were admitted from the emergency department to the medical ward. The goal was to increase the number of patients who had an interval between emergency department assessment/bronchodilator treatment and medical ward assessment/treatment of <120 min.

Methods: A flow chart diagram, a fishbone diagram, data collection, intervention implementation, and data monitoring and analysis were used in this study.

Complications with utilization of positive-pressure devices in a young man with duchenne muscular dystrophy.

Because of the progressive muscle weakness they experience, patients with Duchenne muscular dystrophy frequently utilize positive-pressure devices to maintain adequate bronchial hygiene and ventilation. This case illustrates the course of a 19-y-old male who presented with a perforated right tympanic membrane (TM) following the use of these devices. Perforation of the TM while utilizing positive-pressure devices is a rarely reported event.

Analysis of STAT laboratory turnaround times before and after conversion of the hospital information system.

Background: Modern electronic health record systems (EHRS) reportedly offer advantages including improved quality, error prevention, cost reduction, and increased efficiency. This project reviewed the impact on specimen turnaround times (TAT) and percent compliance for specimens processed in a STAT laboratory after implementation of an upgraded EHRS.

Methods: Before EHRS implementation, laboratory personnel received instruction and training for specimen processing.