Hospital, Multidisciplinary Care Team, Outcomes, Tracheostomy Patients
Conditions
Keywords
Multidisciplinary tracheostomy team, Tracheostomy care, Hospitalised patients with a tracheostomy, Retrospective study, Clinical outcomes, Trachea cannula, tracheostomy related care
Brief summary
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?
Interventions
OTHERThe implementation of the specialised multidisciplinary tracheostomy team.
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.
Sponsors
Vitaz
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Tracheo(s)tomy-related ICU readmission | through study completion, an average of 1 year | Occurrence of readmission to the intensive care unit due to tracheo(s)tomy cannula-related problems. |
| Successful decannulation | through study completion, an average of 1 year | 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. |
| Tracheo(s)tomy-related complications | through study completion, an average of 1 year | Occurrence of predefined canulla-related complications, including airway obstruction, wound infection, bleeding, ... . |
| Performance of FEES | through study completion, an average of 1 year | Performance of a fibreoptic endoscopic evaluation of swallowing (FEES) during hospitalisation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total hospital length of stay | through study completion, an average of 1 year | From hospital admission until hospital discharge |
| Use of high-flow oxygen therapy or active humidification | through study completion, an average of 1 year | Use of high-flow oxygen therapy and/or active humidification during hospitalisation. |
| Time to tracheo(s)tomy | through study completion, an average of 1 year | Number of days from hospital admission to the performance of the tracheo(s)tomy. |
| Time from ICU admission to transfer to an inpatient ward | through study completion, an average of 1 year | Duration of intensive care unit stay before transfer to an inpatient ward. |
| Length of ICU stay following canulla-related readmission | through study completion, an average of 1 year | Duration of intensive care unit stay following readmission due to cannula-related problems. |
| Mortality due to cannulla-related complications | through study completion, an average of 1 year | Occurrence of death attributable to tracheo(s)tomy- or cannula-related complications. |
| Use of a speaking valve | through study completion, an average of 1 year | Occurrence and use of a speaking valve during hospitalisation. |
| Responsible medical discipline | through study completion, an average of 1 year | Location and discipline responsible for tracheostomy placement. |
Countries
Belgium
Contacts
CONTACTLisa Christiaens, MSc
Outcome results
None listed