title: Inadequate follow-up after tracheostomy and intensive care.
abstract: BACKGROUND
  When patients are transferred from intensive care units (ICUs) to general wards with a tracheostomy in situ, there is a risk of suboptimal care and increased morbidity. The aim of this study was to elucidate the management of patients with a tracheostomy in situ at discharge from the ICU to the ward.
  
  
  METHODS
  We performed an electronic questionnaire survey among heads of unit at registered Danish ICUs.
  
  
  RESULTS
  A total of 34 out of 43 ICUs responded. 56% of the ICUs do not document individual plans for decannulation in the patient's chart. 91% of the ICUs do not perform daily follow-up of tracheotomised patients on the ward. No guidelines for decannulation on the ward were found, and only 6% have a guideline for accidental decannulation. Furthermore, as little as 47% of the ICUs report any formalized education or training of staff nurses in the management of tracheotomised patients.
  
  
  CONCLUSIONS
  Guidelines relevant to patients discharged from Danish ICUs with a tracheal cannula in situ are scarce; few ICUs employ individualized plans for tracheostomy management and decannulation; there is largely no daily intensivist-led post-ICU follow-up, and formal staff education in tracheostomy management on the ward is scarce. Altogether these factors create a potential for adverse events and increased morbidity in this high-risk, high-cost patient population. Possibly individualized plans for tracheotomised patients as well as intensivist-led follow-up on the ward can improve patient outcome and safety and this should be confirmed in a future study.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors: Anæstesiologisk Afdeling, Næstved Sygehus, 4700 Næstved, Denmark. frederik.mondrup@gmail.com
authors: Frederik
authors: F
authors: Mondrup
authors: Karen
authors: K
authors: Skjelsager
authors: Kristian Rørbæk
authors: KR
authors: Madsen
mesh_terms: D002983:Clinical Competence; D003266:Continuity of Patient Care / Q000458:organization & administration / Q000592:standards*; D003430:Cross-Sectional Studies; D003718:Denmark; D020878:Device Removal / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D010347:Patient Care Planning / Q000592:standards; D061214:Patient Safety; D010360:Patient Transfer; D017410:Practice Guidelines as Topic; D017064:Process Assessment, Health Care; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000009:adverse effects / Q000193:education / Q000592:standards*