Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2025
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Karen J. Whitt, PhD
Keywords
laryngoscopy, education, patient outcome assessment, video laryngoscopy
Abstract
Background: Prehospital intubation is a critical intervention for airway management in acutely ill patients, yet the choice between video laryngoscopy (VL) and direct laryngoscopy (DL) can lead to variable patient outcomes. While VL is recognized for its superior first-attempt success rates and reduced complications, its adoption remains inconsistent due to the lack of standardized protocols and comprehensive provider education.
Purpose: This project evaluated the effectiveness of an evidence-based VL education initiative to improve pre-hospital providers confidence, VL utilization, and patient outcomes.
Methods: A pre-post intervention design was utilized to assess the impact of the educational initiative, which included an organizational memo and Piktochart presentation covering VL’s advantages, techniques, and preoxygenation strategies. Provider confidence and laryngoscopy preference were measured via pre-post surveys, while retrospective chart reviews analyzed patient outcomes related to laryngoscopy-type used, first attempt success rate, number of attempts, intubation failure rates, high-flow preoxygenation use, and hypoxia during intubation over two consecutive 90-day periods before and after the education program. Data were manually coded in Microsoft Excel and analyzed using descriptive statistics.
Results: After completing the educational program, providers’ confidence with VL significantly increased (X2 (1, n=69) = 5.74, p=.017) from 73.1% (pre) to 93.1% (post). For patient outcomes VL utilization remained consistently high (91.5% pre (n=71) to 91.8% post (n=49)), while first- attempt success rates improved from 86.2% (pre) to 95.5% (post). Total VL success rose from 92.3% (pre) to 100.0% (post). Lastly, patient hypoxia rates decreased from 36.6% (pre) to 30.6% (post), correlating with increased preoxygenation use of 74.6% (pre) to 83.7% (post).
Conclusions & Recommendations: Structured, evidence-based training improved providers’ airway management proficiency and patient outcomes. Results support that VL be established as the standard prehospital intubation method. Future investigations should explore the adaptability of similar programs in diverse prehospital systems.
Copyright Notice
©2025 Bruno Rustico. All rights reserved.
Recommended Citation
Rustico, B. D. (2025). An Education Initiative to Increase the Use of Video Laryngoscopy and Improve Prehospital Patient Outcomes. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/176
Open Access
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