COVID-19 Transmission to Health Care Personnel During Tracheostomy Under a Multidisciplinary Safety Protocol.

Background: Tracheostomies are highly aerosolizing procedures yet are often indicated in patients with COVID-19 who require prolonged intubation. Robust investigations of the safety of tracheostomy protocols and provider adherence and evaluations are limited.

Objectives: To determine the rate of COVID-19 infection of health care personnel involved in COVID-19 tracheostomies under a multidisciplinary safety protocol and to investigate health care personnel's attitudes and suggested areas for improvement concerning the protocol.

Mobilizing outcomes: implementation of a nurse-led multidisciplinary mobility program.

The safety and efficacy of mobility programs for the ventilated patient and the ability to improve outcomes related to immobility of the critically ill are well documented in the literature. Early mobility programs have been proven safe and effective in study. However, a lack of literature describing application of the therapy and integration at the bedside exists.

Building a protocol to guide mobility in the ICU.

Professional experience and wisdom have taught us that immobility is a risk factor for various adverse outcomes, such as deep vein thrombosis, joint contractures, pulmonary dysfunction, and bone demineralization to name a few. Balancing bed rest and mobility may improve both short- and long-term outcomes for our patients. Moreover, early, routine mobilization of critically ill patients is safe and reduces hospital length of stay, shortens the duration of mechanical ventilation, improves muscle strength, and functional independence.