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

作者信息

Jung Yooun-Joong, Kim Younghwan, Kyoung Kyuhyouck, Keum Minae, Kim Taehyun, Ma Dae Seong, Hong Suk-Kyung

机构信息

Department of Nursing, Asan Medical Center, Seoul, Korea.

Department of Surgery, National Medical Center, Seoul, Korea.

出版信息

Acute Crit Care. 2018 Nov;33(4):252-259. doi: 10.4266/acc.2018.00248. Epub 2018 Nov 30.

DOI:10.4266/acc.2018.00248
PMID:31723893
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6849034/
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.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e14/6849034/985d441a89cf/acc-2018-00248f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e14/6849034/2ceee6f69c3e/acc-2018-00248f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e14/6849034/985d441a89cf/acc-2018-00248f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e14/6849034/2ceee6f69c3e/acc-2018-00248f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e14/6849034/985d441a89cf/acc-2018-00248f2.jpg

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J Crit Care. 2013 Apr;28(2):216.e1-10. doi: 10.1016/j.jcrc.2012.05.005. Epub 2012 Aug 27.
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Impact of a specialized multidisciplinary tracheostomy team on tracheostomy care in critically ill patients.专门的多学科气管切开术团队对危重症患者气管切开护理的影响。
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Tracheostomy: why, when, and how?
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Development of a tracheostomy scoring system to guide airway management after major head and neck surgery.开发一种气管切开术评分系统，以指导重大头颈外科手术后的气道管理。
Int J Oral Maxillofac Surg. 2009 Aug;38(8):846-9. doi: 10.1016/j.ijom.2009.03.713. Epub 2009 May 6.
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Intensive Care Med. 2008 Oct;34(10):1878-82. doi: 10.1007/s00134-008-1169-6. Epub 2008 Jun 3.
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