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?
研究概览
地位
研究类型
注册 (估计的)
联系人和位置
学习联系方式
- 姓名:Lisa Christiaens, MSc
- 电话号码:+3237606060
- 邮箱:brecht.serraes@vitaz.be
学习地点
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Oost-Vlaanderen
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Sint-Niklaas、Oost-Vlaanderen、比利时、9100
- Vitaz
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接触:
- Brecht Serraes, Doctor
- 电话号码:+3237602039
- 邮箱:brecht.serraes@vitaz.be
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首席研究员:
- Brecht Serraes, Doctor
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参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
取样方法
研究人群
描述
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
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
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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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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Tracheo(s)tomy-related ICU readmission
大体时间: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
大体时间: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
大体时间: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
大体时间: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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Total hospital length of stay
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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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合作者和调查者
赞助
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他研究编号
- EC26004 (其他标识符:VITAZ, commissie voor medische ethiek)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
研究数据/文件
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