- Title
- An inter-disciplinary nurse-led team approach to the management of patients with a tracheostomy in an acute hospital facility
- Creator
- Parker, Vicki; Giles, Michelle; Shylan, Gai; Austin, Nicole; Archer, Wendy; Smith, Kelvin; Morison, Jane
- Relation
- HNE Handover for Nurses and Midwives Vol. 1, Issue 2, p. 4-9
- Relation
- http://www.newcastle.edu.au/school/nursing-midwifery
- Publisher
- University of Newcastle, Hunter New England NSW Health, University of New England
- Resource Type
- journal article
- Date
- 2008
- Description
- The trend towards early tracheostomy in many Intensive Care Unit (ICU) patients has led to increased numbers of patients receiving tracheostomies. Together with the push to discharge patients earlier from ICU, this poses challenges for clinicians across disciplines and wards. Even though tracheostomy is a procedure performed across a broad range of patient groups, care of the tracheostomy is often seen as the domain of specialist clinicians in critical care and high dependency areas. In the light of increasing demand for beds, it is crucial to ensure quality care is provided regardless of the patient’s destination after leaving the ICU. This paper reports the findings of a study that evaluated an inter-disciplinary team approach to the care of patients with a tracheostomy in non-critical care areas of a large tertiary referral hospital. Aim: To evaluate an interdisciplinary team approach to tracheostomy management in non-critical care areas. Method: A mixed method approach to evaluation was used involving collection and analysis of pre- and post-implementation clinical data and staff surveys, and a post-implementation focus group with team members. (For the purposes of this paper, the terms Pre and Post will differentiate these two groups). Results: Findings revealed a statistically significant reduction in mean length of stay (LOS) in hospital for survivors in the Post group from 50 to 27 days (P<0.0001). There was a statistically significant increase in the number of patients with a tracheostomy in situ transferred to non-critical care wards in the Post group (p=0.006). The number of wards accepting patients from ICU with tracheostomy increased from three to seven during the implementation period. There was also an improvement in levels of knowledge about tracheostomy care and in the confidence of staff in general ward areas. Staff also indicated a growing awareness of the team and its role. Conclusion: Implementation of the team approach has been widely accepted across the organisation with an increasing number of wards indicating willingness to accept patients into their ward. The team themselves report improved efficiency and communication amongst the team resulting in timely referral and better care outcomes for patients.
- Subject
- tracheostomy; inter-disciplinary team; mixed method evaluation
- Identifier
- uon:4990
- Identifier
- http://hdl.handle.net/1959.13/42844
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