Improving Tracheostomy Care in Resource-Limited Settings.

Ann Otol Rhinol Laryngol

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.

Published: February 2020

Objectives: Tracheostomy care in leading pediatric hospitals is both multidisciplinary and comprehensive, including generalized care protocols and thorough family training programs. This level of care is more difficult in resource-limited settings lacking developed healthcare infrastructure and tracheostomy education among nursing and resident staff. The objective of this study was to improve pediatric tracheostomy care in resource-limited settings.

Methods: In collaboration with a team of otolaryngologists, respiratory therapists, tracheostomy nurses, medical illustrators, and global health educators, image-based tracheostomy education materials and low-cost tracheostomy care kits were developed for use in resource-limited settings. In addition, a pilot study was conducted, implementing the image-based tracheostomy pamphlet, manual suctioning device and low-cost ambulatory supply kit ("Go-Bags"), within a low-fidelity simulated training course for nurses and residents in Kigali, Rwanda.

Results: An image-based language and literacy-independent tracheostomy care manual was created and published on OPENPediatrics, an open-access online database of clinician-reviewed learning content. Participants of the training program pilot study reported the course to be of high educational and practical value, and described improved confidence in their ability to perform tracheostomy care procedures.

Conclusions: Outpatient tracheostomy care may be improved upon by implementing image-based tracheostomy care manuals, locally-sourced tracheostomy care kits, and tailored educational material into a low-fidelity simulated tracheostomy care course. These materials were effective in improving technical skills and confidence among nurses and residents. These tools are expected to improve knowledge and skills with outpatient tracheostomy care, and ultimately, to reduce tracheostomy-related complications.

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003489419882972DOI Listing

Publication Analysis

Top Keywords

tracheostomy care
44
tracheostomy
14
care
13
resource-limited settings
12
image-based tracheostomy
12
care resource-limited
8
tracheostomy education
8
care kits
8
pilot study
8
implementing image-based
8

Similar Publications

Background: Invasive mechanical ventilation can present complex challenges for patients with acute brain injury (ABI) in middle-income countries (MICs). We characterized the impact of country income level on weaning strategies and outcomes in patients with ABI.

Methods: A secondary analysis was performed on a registry of critically ill patients with ABI admitted to 73 intensive care units (ICUs) in 18 countries from 2018 to 2020.

View Article and Find Full Text PDF

Objectives: To examine critical care therapy rates after cytoreductive nephrectomy in metastatic kidney cancer patients.

Design, Setting, And Patients: Relying on the National Inpatient Sample (2000-2019), we addressed critical care therapy use (total parenteral nutrition, invasive mechanical ventilation, renal replacement therapy, percutaneous endoscopic gastrostomy tube insertion, and tracheostomy) and in-hospital mortality in surgically treated metastatic kidney cancer patients. Estimated annual percentage changes and multivariable logistic regression models were fitted.

View Article and Find Full Text PDF

Background: Predicting complete liberation from mechanical ventilation (MV) is still challenging. Electrical impedance tomography (EIT) offers a non-invasive measure of regional ventilation distribution and could bring additional information.

Research Question: Whether the display of regional ventilation distribution during a Spontaneous Breathing Trial (SBT) could help at predicting early and successful liberation from MV.

View Article and Find Full Text PDF

Objective: To evaluate the feasibility of adding mechanical insufflation-exsufflation (MI-E) to a weaning protocol for tracheostomized patients undergoing prolonged mechanical ventilation (MV).

Design: Single-center, open-label, randomized, controlled pilot and feasibility study.

Setting: Intensive care unit in Brazil.

View Article and Find Full Text PDF

Medical device-related pressure injuries (MDRPIs) pose a significant risk in the home health environment, where patients may lack continuous professional oversight. Devices commonly used in the home environment with the potential to cause a MDRPI include but are not limited to nasogastric tubes, feeding tubes, nasal cannulas, nasal cannula prongs, airway pressure masks, indwelling urinary catheters, sequential compression devices, dressings, bandages, and tracheostomies. When a medical device is used for an extended period, it can lead to unrelieved pressure or edema, cause friction and/or shearing that impairs sensation, reduces circulation, and alters the microclimate.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!