Premium
Driving standards in tracheostomy care: a preliminary communication of the St Mary’s ENT‐led multi disciplinary team approach
Author(s) -
Arora A.,
Hettige R.,
Ifeacho S.,
Narula A.
Publication year - 2008
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1749-4486.2008.01814.x
Subject(s) - medicine , tracheostomy tube , multidisciplinary approach , audit , multidisciplinary team , mann–whitney u test , population , wilcoxon signed rank test , test (biology) , emergency medicine , nursing , surgery , social science , management , environmental health , sociology , economics , paleontology , biology
Objectives: To assess tracheostomy care and improve standards following the introduction of an ENT‐led multidisciplinary tracheostomy ward round service. Design: Prospective third cycle audit. Setting: Tertiary academic London hospital serving an inner city population of multi‐ethnic background (St Mary’s Hospital, Paddington, London). Participants: Patients with a tracheostomy discharged from ITU to general wards. Implemented actions: • Establishment of an ENT‐led Tracheostomy Multidisciplinary Team (TMDT). • Weekly TMDT ward round to manage patients with a tracheostomy. • ENT‐led educational and training sessions for allied healthcare professionals. Main outcome measures: Compliance with local tracheostomy care guidelines (St Mary’s tracheostomy care bundle) and time to tracheostomy tube decannulation. Results: Preliminary results of 10 patients show improved compliance with tracheostomy care guidelines, established in 2004, rising to 94%. Average time to decannulation was significantly reduced from 21 to 5 days ( P ‐value = 0.0005, Mann Whitney Wilcoxon Test). The mean total tracheostomy time was reduced from 34 to 24 days although this was not statistically significant ( P ‐value = 0.13, Mann Whitney Wilcoxon Test). Conclusions: The introduction of regular ENT‐led multidisciplinary input for patients with a tracheostomy significantly improved compliance with nursing care standards. There was also a reduction in the total length of time tracheostomy tubes remain in situ, with time to decannulation significantly reduced.