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Revista ORL

On-line version ISSN 2444-7986

Abstract

BENITO-OREJAS, José Ignacio et al. Results of applying a safety protocol of the patient with tracheotomy from a critical care unit. Rev. ORL [online]. 2022, vol.13, n.3, pp.211-225.  Epub Nov 21, 2022. ISSN 2444-7986.  https://dx.doi.org/10.14201/orl.28030.

Introduction and objective:

Increasing the number of tracheostomies in critical care units significantly increases morbimortality in the wards. To reverse this, we have implemented a multidisciplinary follow-up program based on training, standardization of care and the adoption of new strategies.

Methodology:

Prospective and observational cohort study of the follow-up of 150 patients in a third-level university hospital that does not have a step-down unit. We record and analyze the clinical and epidemiological variables and the evolution after the application of the program.

Results:

The average age was 61 years old, 67 % male, and 41 % neurocritical care patients. Percutaneous tracheostomy in 71 % of all tracheostomies. Global mortality was 17 % and that of patients with stroke was 6.3 %. Readmission to critical care units was 8 %. Low-severity complications were detected in 23 % of patients. The decannulation process was completed during admission in 43 % of patients, 38 % in all discharged from hospital, 55 % of them with oral feeding now of discharge. Average stay in critical care unit was 34 days and hospital length of stay was 70 days.

Conclusions:

This work describes the results obtained after applying a multidisciplinary follow-up protocol in the wards, of the tracheotomized patient who comes from the critical care units. The purpose of this follow-up is to improve the safety of these patients, to reduce their morbimortality. The application of new strategies will allow their evaluation in relation to the data obtained from this study.

Keywords : tracheotomy; patient safety; quality improvement; critical cares units; multidisciplinary care; complications.

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