Implementation of an interdisciplinary tracheostomy care protocol to decrease rates of tracheostomy-related pressure ulcers and injuries

Daniel J. Carroll, Christopher J. Leto, Zao M. Yang, Mark A. Fritz, Brian Ho, J. Kenneth Byrd, Michael W. Groves, Kevin C. Dellsperger, Stilianos E. Kountakis, Gregory N. Postma

Research output: Contribution to journalArticle

Abstract

Objectives: Tracheostomy-related pressure injuries (TRPI) have been demonstrated to occur in approximately 10% of tracheostomy patients. In this study, we present TRPI outcomes after implementation of a standardized tracheostomy care protocol. Methods: A tracheostomy care protocol was developed by an interdisciplinary quality improvement program and implemented on July 1, 2016. The protocol was designed to minimize factors that contribute to the development of TRPI. Rates of TRPI over the subsequent 20 months were compared to the year before implementation. Results: 9 out of 85 patients (10.6%) developed TRPI in the pre-protocol cohort compared to 0 of 137 (0%) in the post-protocol cohort, which was a statistically significant decrease by Fisher's exact test with a p-value of 0.0001. Pearson's correlation coefficient demonstrated a negative correlation between age and post-operative day of diagnosis (r = −0.641, p = 0.063), indicating that older patients develop TRPI more quickly. Conclusions: Interdisciplinary peri-operative tracheostomy care protocols can be effective in decreasing rates of TRPI.

Original languageEnglish (US)
Article number102480
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume41
Issue number4
DOIs
StatePublished - Jul 1 2020

Keywords

  • Intensive care
  • Pressure ulcer
  • Preventative medicine
  • Tracheostomy
  • Tracheotomy

ASJC Scopus subject areas

  • Otorhinolaryngology

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