Degree Awarded Date
December 15, 2023
Background and Review of Literature: Endotracheal tube cuff pressure should be maintained between 20 to 30 cmH2O to prevent adverse airway outcomes. Standardized practice is not endorsed by any major anesthesia organization nor by Washington University School of Medicine’s Department of Anesthesia. The common practice of manual palpation is unreliable. Use of a manometer is effective to measure and achieve appropriate cuff pressure.
Purpose: Implement a quality improvement project to increase the proportion of anesthesia providers using syringe manometers.
Methods: The facility’s EHR was used to obtain data reports on AG Cuffill syringe manometer use and documentation at specific time points. The independent variable was staff educational in-services; the dependent variable was the proportion of documented ETT cuff pressures in the EHR.
Implementation Plan/Procedure: This quality improvement project consisted of pre-intervention, implementation, and post-intervention phases. Educational in-services were provided two days a week for two weeks at the start of the intervention phase. The in-services aimed to improve provider knowledge and familiarity with syringe manometer use as well as appropriate documentation.
Implications/Conclusion: Educational in-services increased the proportion of providers who used and documented syringe cuff manometry. Improved provider adherence may eventually lead to implementation of an established departmental practice for all anesthetics delivered with a cuffed ETT to improve patient outcomes.
Perez, Sarah DNP, CRNA (Chair) Barnes Jewish College, Goldfarb School of Nursing
Beyatte, Beth DNP, ANP-BC, ACNP-BC (Committee Member) Barnes Jewish College, Goldfarb School of Nursing
Kentner, Rainer MD (Mentor) Washington University School of Medicine in St. Louis
Komen, Helga MD (Mentor) Washington University School of Medicine in St. Louis
Davenport, Emily; Stephan, Jennifer; and Winson, Paul, "Implementation of Endotracheal Tube Cuff Manometry in the Operating Room: A Quality Improvement Project" (2023). Doctor of Nursing Practice (DNP) Student Projects. Paper 12.