Assessment of knowledge regarding tracheostomy care and management of early complications among healthcare professionals

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Highlights

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Healthcare workers should be well versed in identifying tracheostomy management, its complications and responding accordingly.
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Doctors and nurses (131 = 52%) possessed good knowledge about various aspects of tracheostomy care and management.
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The poorest scores were regarding cuff pressure (38.9%), suction pressure (39.4%) and first response in tube blockade (31.1%).
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Higher scores were found in age group 26 to 30 years (54.2%) and those having 1-3 years of clinical experience (41.2%).
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No statistically significant assoiation of knowledge regarding tracheostomy care was apparent with age, gender or years of practice.

Abstract

Introduction

Tracheostomy is commonly performed surgical procedure in ENT practice. Postoperative care is the most important aspect for achieving good patient outcomes. Unavailability of standard guidelines on tracheostomy management and inadequate training can make this basic practice complex. The nursing staff and doctors play a very important role in bedside management, both in the ward and in the intensive care unit (ICU) setup. Therefore, it is crucial that all healthcare providers directly involved in providing postoperative care to such patients can do this efficiently.

Objectives

The objective of this study is to assess the knowledge regarding identification and management of tracheostomy-related emergencies and early complications among healthcare professionals so as to improve practice and further standardization.

Methods

Cross-sectional observational study included two hundred and fifty-four doctors and nurses from four large tertiary care hospitals. The questions used were simple and straightforward regarding tracheostomy suctioning, cuff care, cuff management, tube blockage, and feeding management in patients with tracheostomy.

Results

Based on evidence from our study, knowledge level regarding tracheostomy care ranges from 48% to 52% with knowledge scores above 50% being considered satisfactory. Significant gaps in knowledge exist in various aspects of tracheostomy care and management among healthcare professionals.

Conclusion

Our findings demonstrated an adequate knowledge level among health care professionals ranging from 48% to 52% with knowledge scores above 50% being considered satisfactory and revealed that gaps in knowledge still exist in various aspects of tracheostomy care and management.

Related collections

Most cited references 32

Record: found
Abstract: found
Article: not found

Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients.

J Stauffer, Eric Olson, Rafe Petty (1980)

A prospective study of the complications and consequences of translaryngeal endotracheal intubation and tracheotomy was conducted on 150 critically ill adult patients. Adverse consequences occurred in 62 percent of all endotracheal intubations and in 66 percent of all tracheotomies during placement and use of the artificial airways. The most frequent problems during endotracheal intubation were excessive cuff pressure requirements (19 percent), self-extubation (13 percent) and inability to seal the airway (11 percent). Patient discomfort and difficulty in suctioning tracheobronchial secretions were very uncommon. Problems with tracheotomy included stomal infection (36 percent), stomal hemorrhage (36 percent), excessive cuff pressure requirements (23 percent) and subcutaneous emphysema or pneumomediastinum (13 percent). Complications of tracheotomy were judged to be more severe than those of endotracheal intubation. Follow-up studies of survivors revealed a high prevalence of tracheal stenosis after tracheotomy (65 percent) and significantly less after endotracheal intubation (19 percent)(p < 0.01). Thirty-nine of 41 (95 percent) patients with endotracheal intubation and 20 of 22 (91 percent) patients with tracheotomy had laryngotracheal injury at autopsy. Ulcers on the posterior aspect of the true vocal cords were found at autopsy in 51 percent of the patients who died after endotracheal intubation. There was no significant relationship between the duration of endotracheal intubation or tracheotomy and the over-all amount of laryngotracheal injury at autopsy, although patients with prolonged endotracheal intubation followed by tracheotomy had more laryngeal injury at autopsy (P = 0.06) and more frequent tracheal stenosis (P = 0.05) than patients with short-term endotracheal intubation followed by tracheotomy. Adverse effects of both endotracheal intubation and tracheotomy are common. The value of tracheotomy when an artificial airway is required for periods as long as three weeks is not supported by data obtained in this study.

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Record: found
Abstract: found
Article: not found

Tracheostomy: why, when, and how?

Charles G Durbin (2010)

Tracheostomy is one of the most frequent procedures performed in intensive care unit (ICU) patients. Of the many purported advantages of tracheostomy, only patient comfort, early movement from the ICU, and shorter ICU and hospital stay have significant supporting data. Even the belief of increased safety with tracheostomy may not be correct. Various techniques for tracheostomy have been developed; however, use of percutaneous dilation techniques with bronchoscopic control continue to expand in popularity throughout the world. Tracheostomy should occur as soon as the need for prolonged intubation (longer than 14 d) is identified. Accurate prediction of this duration by day 3 remains elusive. Mortality is not worse with tracheotomy and may be improved with earlier provision, especially in head-injured and critically ill medical patients. The timing of when to perform a tracheostomy continues to be individualized, should include daily weaning assessment, and can generally be made within 7 days of intubation. Bedside techniques are safe and efficient, allowing timely tracheostomy with low morbidity.

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Record: found
Abstract: found
Article: not found

Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies.

B McGrath, David Moore, R. Bates … (2012)

Adult tracheostomy and laryngectomy airway emergencies are uncommon, but do lead to significant morbidity and mortality. The National Tracheostomy Safety Project incorporates key stakeholder groups with multi-disciplinary expertise in airway management. , the Intensive Care Society, the Royal College of Anaesthetists, ENT UK, the British Association of Oral and Maxillofacial Surgeons, the College of Emergency Medicine, the Resuscitation Council (UK) the Royal College of Nursing, the Royal College of Speech and Language Therapists, the Association of Chartered Physiotherapists in Respiratory Care and the National Patient Safety Agency. Resources and emergency algorithms were developed by consensus, taking into account existing guidelines, evidence and experiences. The stakeholder groups reviewed draft emergency algorithms and feedback was also received from open peer review. The final algorithms describe a universal approach to managing such emergencies and are designed to be followed by first responders. The project aims to improve the management of tracheostomy and laryngectomy critical incidents. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

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Author and article information

Contributors

Tahseer Khan

Journal

Journal ID (nlm-ta): Braz J Otorhinolaryngol

Journal ID (iso-abbrev): Braz J Otorhinolaryngol

Title: Brazilian Journal of Otorhinolaryngology

Publisher: Elsevier

ISSN (Print): 1808-8694

ISSN (Electronic): 1808-8686

Publication date PMC-release: 06 August 2021

Publication date Collection: Mar-Apr 2022

Publication date (Electronic): 06 August 2021

Volume: 88

Issue: 2

Pages: 251-256

Affiliations

[a ]Department of Otolaryngology, Head & Neck Surgery (ENT), DIMC (Ohja Campus), DUHS, Karachi, Pakistan

[b ]Department of Pulmonary and Critical Care, DIMC, DUHS (Ojha Campus), Karachi, Pakistan

[c ]Aga Khan University, Department of Critical Care Medicine, Department of Anesthesiology, Pakistan

[d ]Jinnah Post Graduate Medical Centre, Department of Surgery, Karachi, Pakistan

[e ]Dow University of Health Sciences, School of Public Health, Karachi, Pakistan

Author notes

[* ]Corresponding author. dr.tahseerkhan7@ 123456gmail.com

Article

Publisher Item ID: S1808-8694(21)00135-X

DOI: 10.1016/j.bjorl.2021.06.011

PMC ID: 9422647

PubMed ID: 34419386

SO-VID: 60db0936-b216-4508-ab23-e8106e6559d8

License:

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

History

Date received : 18 November 2020

Date accepted : 28 June 2021

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