Tracheostomy Care – A Multidisciplinary Approach

Tracheostomy Care – A Multidisciplinary Approach


Name: Troy Chandler

Rank: 1LT

Presenter/Poster: Accepted - no presentation due to COVID19 response

Year: 2020


Description of the problem: Tracheostomies are low volume, high risk invasive medical devices that can result in negative patient outcomes when staff is unfamiliar with the device. Our surgical telemetry unit had 5 tracheostomies for 2019, 9 for 2018, and 5 in 2017. Since tracheostomies are low volume the staff voiced concern regarding familiarity with taking care of a patient with a tracheostomy.

PICOT Question: On an inpatient surgical telemetry unit will in-service training on tracheostomy care increase knowledge deficits of staff?

Methods: Using the IOWA model, a focused question was developed and literature review was completed. A pre-test was collected to determine the staff’s baseline knowledge in regards to tracheostomy care. Collaboration with an ICU advanced practice nurse, a surgical advanced practice nurse and a Respiratory Therapist to establish a standard tracheostomy care protocol for staff utilization. A tracheostomy in-service was developed and provided to staff. After training was completed, post- tests were collected to determine if staff knowledge had improved.

Project Findings: Pre-Test results identified deficits in the following areas: 4 out of 33 knew what to do when oxygen levels dropped during tracheostomy care, 11 out of 33 knew how many seconds to let the patient recover before suctioning again, 9 out of 33 knew what solution to use for tube care, 3 out of 33 knew what to observe for skin assessment around tracheostomy. Overall the pre-test showed an average score of 57.6% After the tracheostomy in-service was implemented, a post-test was completed in which 33 staff participated. Results showed improvement in knowledge with a post-test average of 99%.

Implications for Military Nursing: This project will significantly increase staff’s knowledge and skill sets pertaining to tracheostomy care. Having a standardized tracheostomy care protocol will help guide nursing staff to perform tracheostomy care safely to protect both staff and patients.