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

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.