Acute and Critical Care

Korean Society of Critical Care Medicine (대한중환자의학회)
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The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward

  • Jung, Yooun-joong (Department of Nursing, Asan Medical Center) ;
  • Kim, Younghwan (Department of Surgery, National Medical Center) ;
  • Kyoung, Kyuhyouck (Department of Surgery, Ulsan University Hospital) ;
  • Keum, Minae (Department of Surgery, Ulsan University Hospital) ;
  • Kim, Taehyun (Department of Surgery, National Medical Center) ;
  • Ma, Dae seong (Department of Trauma Surgery, Gil Medical Center, Gachon University College of Medicine) ;
  • Hong, Suk-Kyung (Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.07.26
  • Accepted : 2018.11.16
  • Published : 2018.11.30
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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 ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, 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.

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References

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