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- Ensayo clínico NCT07755969
Evaluation of a Specialised Tracheostomy Team for the Management of Patients With a Tracheostomy Cannula in a Belgium General Hospital: A Retrospective Study.
Management of Patients With a Tracheostomy Cannula by a Specialised Team in a Belgium General Hospital: A Retrospective Study
Patients admitted to intensive care units (ICUs) frequently require prolonged mechanical ventilation. Difficulties in weaning from mechanical ventilation represent an important indication for performing a tracheotomy, which involves creating a temporary opening in the trachea into which a cannula is inserted. This procedure is often confused with a tracheostomy, in which a permanent stoma is created.
Tracheotomy offers several clinical benefits, including increased patient comfort, reduced sedation requirements, decreased work of breathing, improved oral hygiene, a lower risk of ventilator-associated pneumonia, and lower mortality. With the increasing use of the percutaneous technique, the procedure is increasingly performed by intensivists. Consequently, the number of patients with a tracheostomy cannula in the ICU is increasing.
Following clinical stabilisation, these patients are transferred to inpatient wards throughout the hospital according to their underlying pathology. However, nurses working on these wards encounter tracheostomy-related care less frequently, which may include suctioning, wound care, cannula care, and decannulation.
Despite the availability of clinical procedures and protocols, a lack of knowledge, skills, and confidence in providing safe tracheostomy-related care persists. This increases the risk of complications such as cannula obstruction, infection, hypoxaemia, dislodgement, and bleeding. To address this issue, specialised multidisciplinary tracheostomy teams are increasingly being implemented.
The aim of this retrospective study is to answer the following research question: What is the impact of a specialised multidisciplinary tracheostomy team on clinical outcomes in hospitalised patients with a tracheostomy cannula?
Descripción general del estudio
Estado
Intervención / Tratamiento
Tipo de estudio
Inscripción (Estimado)
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Lisa Christiaens, MSc
- Número de teléfono: +3237606060
- Correo electrónico: brecht.serraes@vitaz.be
Ubicaciones de estudio
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Oost-Vlaanderen
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Sint-Niklaas, Oost-Vlaanderen, Bélgica, 9100
- Vitaz
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Contacto:
- Brecht Serraes, Doctor
- Número de teléfono: +3237602039
- Correo electrónico: brecht.serraes@vitaz.be
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Investigador principal:
- Brecht Serraes, Doctor
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Niño
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Método de muestreo
Población de estudio
Descripción
Inclusion Criteria:
- Hospitalisation between 2010 and 2026 in VITAZ (general hospital, Belgium)
- Age ≥18 years.
- Presence of a tracheostomy cannula (tracheotomy, permanent tracheostomy, or laryngectomy).
- Curative and palliative patients will be included.
Exclusion Criteria:
- Ambulatory care
- Day hospitalisation
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
Intervención / Tratamiento |
|---|---|
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Pre-intervention cohort: Before specialised tracheostomy team implementation
Hospitalised patients with a tracheostomy cannula who received routine clinical care before the establishment and implementation of the specialised multidisciplinary tracheostomy team.
This cohort serves as the pre-intervention comparison group.
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Post-intervention cohort: After specialised tracheostomy team implementation
Hospitalised patients with a tracheostomy cannula who received care after the establishment and implementation of the specialised multidisciplinary tracheostomy team.
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The intervention of interest is the implementation of the specialised multidisciplinary tracheostomy team, which provides structured, team-based care for patients with a tracheostomy cannula.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Tracheo(s)tomy-related ICU readmission
Periodo de tiempo: through study completion, an average of 1 year
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Occurrence of readmission to the intensive care unit due to tracheo(s)tomy cannula-related problems.
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through study completion, an average of 1 year
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Successful decannulation
Periodo de tiempo: through study completion, an average of 1 year
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Successful decannulation of the tracheo(s)tomy cannula according to predefined criteria derived from the literature.
The proportion of patients achieving successful decannulation will be compared between the pre-intervention and post-intervention cohorts.
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through study completion, an average of 1 year
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Tracheo(s)tomy-related complications
Periodo de tiempo: through study completion, an average of 1 year
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Occurrence of predefined canulla-related complications, including airway obstruction, wound infection, bleeding, ... .
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through study completion, an average of 1 year
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Performance of FEES
Periodo de tiempo: through study completion, an average of 1 year
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Performance of a fibreoptic endoscopic evaluation of swallowing (FEES) during hospitalisation.
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through study completion, an average of 1 year
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Total hospital length of stay
Periodo de tiempo: through study completion, an average of 1 year
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From hospital admission until hospital discharge
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through study completion, an average of 1 year
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Use of high-flow oxygen therapy or active humidification
Periodo de tiempo: through study completion, an average of 1 year
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Use of high-flow oxygen therapy and/or active humidification during hospitalisation.
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through study completion, an average of 1 year
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Time to tracheo(s)tomy
Periodo de tiempo: through study completion, an average of 1 year
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Number of days from hospital admission to the performance of the tracheo(s)tomy.
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through study completion, an average of 1 year
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Time from ICU admission to transfer to an inpatient ward
Periodo de tiempo: through study completion, an average of 1 year
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Duration of intensive care unit stay before transfer to an inpatient ward.
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through study completion, an average of 1 year
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Length of ICU stay following canulla-related readmission
Periodo de tiempo: through study completion, an average of 1 year
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Duration of intensive care unit stay following readmission due to cannula-related problems.
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through study completion, an average of 1 year
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Mortality due to cannulla-related complications
Periodo de tiempo: through study completion, an average of 1 year
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Occurrence of death attributable to tracheo(s)tomy- or cannula-related complications.
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through study completion, an average of 1 year
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Use of a speaking valve
Periodo de tiempo: through study completion, an average of 1 year
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Occurrence and use of a speaking valve during hospitalisation.
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through study completion, an average of 1 year
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Responsible medical discipline
Periodo de tiempo: through study completion, an average of 1 year
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Location and discipline responsible for tracheostomy placement.
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through study completion, an average of 1 year
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Colaboradores e Investigadores
Patrocinador
Publicaciones y enlaces útiles
Publicaciones Generales
- Ninan A, Grubb LM, Brenner MJ, Pandian V. Effectiveness of interprofessional tracheostomy teams: A systematic review. J Clin Nurs. 2023 Oct;32(19-20):6967-6986. doi: 10.1111/jocn.16815. Epub 2023 Jul 3.
- Speed L, Harding KE. Tracheostomy teams reduce total tracheostomy time and increase speaking valve use: a systematic review and meta-analysis. J Crit Care. 2013 Apr;28(2):216.e1-10. doi: 10.1016/j.jcrc.2012.05.005. Epub 2012 Aug 27.
- Parker V, Giles M, Shylan G, Austin N, Smith K, Morison J, Archer W. Tracheostomy management in acute care facilities--a matter of teamwork. J Clin Nurs. 2010 May;19(9-10):1275-83. doi: 10.1111/j.1365-2702.2009.03155.x. Epub 2010 Mar 18.
- Holmes TR, Cumming BD, Sideris AW, Lee JW, Briggs NE, Havas TE. Multidisciplinary Tracheotomy Teams: An Analysis of Patient Outcomes and Resource Allocation. Ear Nose Throat J. 2019 Apr-May;98(4):232-237. doi: 10.1177/0145561319840103. Epub 2019 Apr 2.
- Garrubba M, Turner T, Grieveson C. Multidisciplinary care for tracheostomy patients: a systematic review. Crit Care. 2009;13(6):R177. doi: 10.1186/cc8159. Epub 2009 Nov 6.
- Brenner MJ, Pandian V, Milliren CE, Graham DA, Zaga C, Morris LL, Bedwell JR, Das P, Zhu H, Lee Y Allen J, Peltz A, Chin K, Schiff BA, Randall DM, Swords C, French D, Ward E, Sweeney JM, Warrillow SJ, Arora A, Narula A, McGrath BA, Cameron TS, Roberson DW. Global Tracheostomy Collaborative: data-driven improvements in patient safety through multidisciplinary teamwork, standardisation, education, and patient partnership. Br J Anaesth. 2020 Jul;125(1):e104-e118. doi: 10.1016/j.bja.2020.04.054. Epub 2020 May 23.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Otros números de identificación del estudio
- EC26004 (Otro identificador: VITAZ, commissie voor medische ethiek)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Datos del estudio/Documentos
Información sobre medicamentos y dispositivos, documentos del estudio
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