Abstract：
INTRODUCTION:When patients are transferred from intensive care units (ICUs) to general wards with a tracheostomy in situ, there is a risk of suboptimal care and increased morbidity. The aim of this study was to elucidate the management of patients with a tracheostomy in situ at discharge from the ICU to the ward. MATERIAL AND METHODS:We performed an electronic questionnaire survey among heads of unit at registered Danish ICUs. RESULTS:A total of 34 out of 43 ICUs responded. 56% of the ICUs do not document individual plans for decannulation in the patient's chart. 91% of the ICUs do not perform daily follow-up of tracheotomised patients on the ward. No guidelines for decannulation on the ward were found, and only 6% have a guideline for accidental decannulation. Furthermore, as little as 47% of the ICUs report any formalized education or training of staff nurses in the management of tracheotomised patients. CONCLUSION:Guidelines relevant to patients discharged from Danish ICUs with a tracheal cannula in situ are scarce; few ICUs employ individualized plans for tracheostomy management and decannulation; there is largely no daily intensivist-led post-ICU follow-up, and formal staff education in tracheostomy management on the ward is scarce. Altogether these factors create a potential for adverse events and increased morbidity in this high-risk, high-cost patient population. Possibly individualized plans for tracheotomised patients as well as intensivist-led follow-up on the ward can improve patient outcome and safety and this should be confirmed in a future study. FUNDING:not relevant. TRIAL REGISTRATION:not relevant.
journal_name
Dan Med Jjournal_title
Danish medical journalauthors
Mondrup F,Skjelsager K,Madsen KRsubject
Has Abstractpub_date
2012-08-01 00:00:00pages
A4481issue
8issn
2245-1919pii
A4481journal_volume
59pub_type
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