Prevention of Tracheostomy‐Related Hospital‐Acquired Pressure Ulcers
| Autor: | Jill S. Jeffe, Thomas R. O’Toole, Brian M. Hondorp, Laura Crawford, Natalie Jacobs, Brian D. Stein, Phillip S. LoSavio, Lisa R. Boudreau |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Iatrogenic Disease Polyurethanes Tracheostomy Procedure 03 medical and health sciences Tracheostomy 0302 clinical medicine Suture (anatomy) medicine Retrospective analysis Humans Tracheostomy care 030223 otorhinolaryngology Retrospective Studies Postoperative Care Pressure Ulcer Hydrocolloid dressing 030504 nursing business.industry Incidence (epidemiology) Significant difference Perioperative Middle Aged Bandages Surgery Otorhinolaryngology Female 0305 other medical science business Bandages Hydrocolloid |
| Zdroj: | Otolaryngology–Head and Neck Surgery. 156:642-651 |
| ISSN: | 1097-6817 0194-5998 |
| DOI: | 10.1177/0194599816689584 |
| Popis: | Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head. One year after the bundle was initiated, a retrospective analysis was performed to compare the percentage of tracheostomy patients who developed pressure ulcers versus the preintervention period. Results The incidence of tracheostomy-related pressure ulcers decreased from 20 of 183 tracheostomies (10.93%) prior to use of the standardized protocol to 2 of 155 tracheostomies (1.29%). Chi-square analysis showed a significant difference between the groups, with a P value of .0003. Discussion Adoption of this care bundle at our institution resulted in a significant reduction in the incidence of hospital-acquired tracheostomy-related pressure ulcers. The impact of any single intervention within our protocol was not assessed and could be an area of further investigation. Implications for Practice Adoption of a standardized posttracheostomy care bundle at the institution level may result in the improved care of patients with tracheostomies and specifically may reduce the incidence of pressure ulcers. |
| Databáze: | OpenAIRE |
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