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KMID : 1144420180330040252
Acute and Critical Care
2018 Volume.33 No. 4 p.252 ~ p.259
The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward
Jung Yooun-Joong

Kim Young-Hwan
Kyoung Kyu-Hyouck
Keum Min-Ae
Kim Tae-Hyun
Ma Dae-Seong
Hong Suk-Kyung
Abstract
Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward.

Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU.

Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time (26.7¡¾25.1 vs. 12.1¡¾16.0 days, P=0.003),length of stay in the general ward (70.6¡¾89.1 vs. 40.5¡¾42.2 days, P=0.008), length of total hospital stay (107.5¡¾95.6 vs. 74.7¡¾51.2 days, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010).

Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.
KEYWORD
intensive care units, respiratory care, tracheostomy
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