Driving standards in tracheostomy care: a preliminary communication of the St Mary's ENT-led multi disciplinary team approach.
OBJECTIVE
To assess tracheostomy care and improve standards following the introduction of an ENT-led multidisciplinary tracheostomy ward round service.


METHODS
Prospective third cycle audit.


METHODS
Tertiary academic London hospital serving an inner city population of multi-ethnic background (St Mary's Hospital, Paddington, London).


METHODS
Patients with a tracheostomy discharged from ITU to general wards. IMPLEMENTED ACTIONS: Establishment of an ENT-led Tracheostomy Multidisciplinary Team (TMDT). Weekly TMDT ward round to manage patients with a tracheostomy. ENT-led educational and training sessions for allied healthcare professionals.


METHODS
Compliance with local tracheostomy care guidelines (St Mary's tracheostomy care bundle) and time to tracheostomy tube decannulation.


RESULTS
Preliminary results of 10 patients show improved compliance with tracheostomy care guidelines, established in 2004, rising to 94%. Average time to decannulation was significantly reduced from 21 to 5 days (P-value = 0.0005, Mann Whitney Wilcoxon Test). The mean total tracheostomy time was reduced from 34 to 24 days although this was not statistically significant (P-value = 0.13, Mann Whitney Wilcoxon Test).


CONCLUSIONS
The introduction of regular ENT-led multidisciplinary input for patients with a tracheostomy significantly improved compliance with nursing care standards. There was also a reduction in the total length of time tracheostomy tubes remain in situ, with time to decannulation significantly reduced.
Arora
A
A
Department of Otolaryngology, St Mary's Hospital, London, UK.
Hettige
R
R
Ifeacho
S
S
Narula
A
A
D000328:Adult; D000368:Aged; D019983:Guideline Adherence; D006786:Hospitals, Urban / Q000592:standards; D006801:Humans; D008131:London; D008485:Medical Audit; D008875:Middle Aged; D009732:Nursing Care / Q000592:standards; D005791:Patient Care / Q000592:standards*; D010348:Patient Care Team / Q000592:standards*; D012189:Retrospective Studies; D014139:Tracheostomy / Q000592:standards