Tracheostomy care quality improvement in low- and middle-income countries: A scoping review.

Autor:	Selekwa M; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Maina I; Department of Otolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America., Yeh T; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America., Nkya A; Department of Otolaryngology-Head & Neck Surgery, Muhimbili National Hospital, Dar es Salaam, Tanzania., Ncogoza I; Department of Surgery, College of Medicine & Health Sciences, University of Rwanda, Kigali, Rwanda., Nuss RC; Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, United States of America., Mushi BP; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Haddadi S; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Van Loon K; Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, California, United States of America., Mbaga E; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Massawe W; Department of Otolaryngology-Head & Neck Surgery, Muhimbili National Hospital, Dar es Salaam, Tanzania.; Department of Otolaryngology-Head and Neck Surgery, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania., Roberson DW; Bayhealth Medical Group, Dover, Delaware, United States of America.; Global Tracheostomy Collaborative, Raleigh, North Carolina, United States of America., Dharsee N; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.; Ocean Road Cancer Institute, Dar es Salaam, Tanzania., Musimu B; Department of Otolaryngology-Head and Neck Surgery, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania., Xu MJ; Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, United States of America.; National Clinician Scholars Program, University of California San Francisco, San Francisco, California, United States of America.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Nov 09; Vol. 3 (11), pp. e0002294. Date of Electronic Publication: 2023 Nov 09 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0002294
Abstrakt:	Tracheostomy is a lifesaving, essential procedure performed for airway obstruction in the case of head and neck cancers, prolonged ventilator use, and for long-term pulmonary care. While successful quality improvement interventions in high-income countries such as through the Global Tracheostomy Collaborative significantly reduced length of hospital stay and decreased levels of anxiety among patients, limited literature exists regarding tracheostomy care and practices in low and middle-income countries (LMIC), where most of the world resides. Given limited literature, this scoping review aims to summarize published tracheostomy studies in LMICs and highlight areas in need of quality improvement and clinical research efforts. Based on the PRISMA guidelines, a scoping review of the literature was performed through MEDLINE/PubMed and Embase using terms related to tracheostomy, educational and quality improvement interventions, and LMICs. Publications from 2000-2022 in English were included. Eighteen publications representing 10 countries were included in the final analysis. Seven studies described baseline needs assessments, 3 development of training programs for caregivers, 6 trialed home-based or hospital-based interventions, and finally 2 articles discussed development of standardized protocols. Overall, studies highlighted the unique challenges to tracheostomy care in LMICs including language, literacy barriers, resource availability (running water and electricity in patient homes), and health system access (financial costs of travel and follow-up). There is currently limited published literature on tracheostomy quality improvement and care in LMICs. Opportunities to improve quality of care include increased efforts to measure complications and outcomes, implementing evidence-based interventions tailored to LMIC settings, and using an implementation science framework to study tracheostomy care in LMICs. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Selekwa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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