Evaluating the Use of a Stability Guideline for Long-Term Ventilator–Dependent Children Discharging to Home: A Quality Improvement Project

Abstract

Introduction Defining stability before discharge for children with severe chronic lung disease requiring home ventilation has historically been dependent on an individual provider's opinion. Methods An institutional guideline based on expert opinion was used for patients who were first discharged home on mechanical ventilation. A retrospective review determined if the guideline was used. Electronic medical record changes were initiated to improve compliance with the guideline. Results The retrospective review showed that the guideline is documented in less than one third of patients, and 36% of patients met the requirements of the guideline before discharge. Following these results, electronic medical record documentation was changed. Discussion Results showed a low utilization rate for the discharge home guideline for patients receiving long-term ventilation. Utilization of electronic medical record charting can improve the tracking of stability guidelines and provide the opportunity to further define stability in ventilator-dependent children.