Acute Crit Care.  2018 Nov;33(4):252-259. 10.4266/acc.00248.

The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward

• Jung YJ
• Kim Y
• Kyoung K
• Keum M
• Kim T
• Ma DS
• Hong SK

• KMID: 2441243
• DOI: http://doi.org/10.4266/acc.00248

Abstract

BACKGROUND
The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward.
METHODS
In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU.
RESULTS
The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time (26.7±25.1 vs. 12.1±16.0 days, P=0.003), length of stay in the general ward (70.6±89.1 vs. 40.5±42.2 days, P=0.008), length of total hospital stay (107.5±95.6 vs. 74.7±51.2 days, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010).
CONCLUSIONS
Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

Keyword

intensive care units; respiratory care; tracheostomy

MeSH Terms

Critical Care*
Electronic Health Records
Humans
Intensive Care Units
Length of Stay
Nurse Clinicians
Patients' Rooms*
Retrospective Studies
Tracheostomy*

Figure

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  Figure 1. Flow diagram of preintervention and postintervention patient enrollment. SICU: surgical intensive care unit; GW: general ward.

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  Figure 2. Comparison of pre- and postintervention tracheostomy care. TR: tracheostomy; CNS: clinical nurse specialist.

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