Tracheostomy Care Practices In A Simulated Setting: An Exploratory Study

Keywords

simulation; trach care; tracheostomy; tracheostomy care

Abstract

Purpose/Aims: Many critically ill patients undergo a tracheostomy. Tracheostomy care is performed to maintain the airway and promote stoma skin integrity. Variation in practices may affect outcomes. The study purpose was to describe tracheostomy care practices of caregivers who perform tracheostomy care in critical care settings and compare practices with published recommendations. Design: This is a descriptive, exploratory study of tracheostomy care practices of nurses and respiratory therapists using a simulated setting. Methods: Staff working in critical care and step-down units were approached to participate in the study. Equipment used for tracheostomy care and the steps performed were observed and video recorded. Observations were compared with recommended practices. Data were analyzed with descriptive statistics. Results: Fifteen registered nurses (75%) and 5 respiratory therapists (25%) participated. Most participants (80%) were female and held a baccalaureate degree; median experience was 5 years. Equipment used and order of steps varied widely. Only 1 individual performed in the order recommended in a commonly used procedure manual. The most common sequence performed was hand hygiene, clean flange, clean stoma, change inner cannula, change ties, and apply dressing. Conclusion: Wide variability in equipment and practices emphasizes the need for establishing an evidence-based approach for performing tracheostomy care to prevent complications.

Publication Date

7-1-2018

Publication Title

Clinical Nurse Specialist

Volume

32

Issue

4

Number of Pages

182-188

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1097/NUR.0000000000000385

Socpus ID

85048963026 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85048963026

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