The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward
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Background: The aim of this study was to investigate the effects of using a systematic approachto tracheostomy care by a clinical nurse specialist and surgical intensivists for patientswith a tracheostomy who were transferred from the surgical intensive care unit (SICU) to thegeneral ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomywho were transferred to the general ward. The study period was divided into a preinterventionperiod (January 1, 2007 to December 31, 2010) and a postintervention period (January1, 2011 to December 31, 2014), and electronic medical records were used to analyze andcompare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in thepostintervention 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 totalhospital stay (107.5±95.6 vs. 74.7±51.2 days, P=0.009), and readmission rate of SICU decreaseddue 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 toreduction in decannulation time through professional management, which resulted in ashorter hospital stay. It also lowered SICU readmission by solving problems related to direct Tcannula.
Abstract
Background: The aim of this study was to investigate the effects of using a systematic approachto tracheostomy care by a clinical nurse specialist and surgical intensivists for patientswith a tracheostomy who were transferred from the surgical intensive care unit (SICU) to thegeneral ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomywho were transferred to the general ward. The study period was divided into a preinterventionperiod (January 1, 2007 to December 31, 2010) and a postintervention period (January1, 2011 to December 31, 2014), and electronic medical records were used to analyze andcompare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in thepostintervention 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 totalhospital stay (107.5±95.6 vs. 74.7±51.2 days, P=0.009), and readmission rate of SICU decreaseddue 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 toreduction in decannulation time through professional management, which resulted in ashorter hospital stay. It also lowered SICU readmission by solving problems related to direct Tcannula.
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