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Tracheostomy training

Harriet Mortimer, Haytham Kubba
The National Confidential Enquiry into Patient Outcome and Death recently conducted a large, robust study investigating tracheostomy care for patients in England, Wales and Northern Ireland. They found up to 31% of tracheostomy patients experience a complication at some stage in their care, many of which were serious. This study aims to explore the nature of adverse events and complications affecting tracheostomy patients across the diverse hospitals of NHS Greater Glasgow and Clyde (NHSGGC) including both adult and paediatric populations over a 6-year period between 2008 and 2014...
October 19, 2016: Clinical Otolaryngology
Seung Tae Lee, Min Gyun Kim, Jae Ho Jeon, Joo Hee Jeong, Seung Ki Min, Joo Yong Park, Sung Weon Choi
BACKGROUND: This study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications. METHODS: We performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Sarah A Sobotka, Lindsey P Hird-McCorry, Denise M Goodman
BACKGROUND AND OBJECTIVES: The core mission of the Pulmonary Habilitation Program is to train and prepare caregivers for the care of a ventilated child in the home. It exists within a free-standing children's hospital. The program is supported by a multidisciplinary staff and serves ∼100 children. Through standardizing electronic documentation with process-specific tracking for the discharge process, the Pulmonary Habilitation Program team sought to identify intervention opportunities for more efficient and effective discharges...
September 2016: Hospital Pediatrics
Philip A Gaudreau, Hannah Greenlick, Tiffany Dong, Michelle Levy, Alyssa Hackett, Diego Preciado, George Zalzal, Brian K Reilly
Importance: Pediatric tracheostomy is commonly performed for upper airway obstruction and prolonged mechanical ventilation. Children undergoing tracheostomy typically have multiple chronic medical problems that place them at high risk for readmission and additional complications. Objective: To determine whether the institution of a postoperative protocol for parent education and wound care with a nurse trained in tracheostomy care decreases the rate of readmission and other complications...
July 28, 2016: JAMA Otolaryngology—Head & Neck Surgery
Paola Cerutti, Valentina Solara, Silvia Rossi Ferrario
The approach to patients affected by motor neuron disease (MND) and their caregivers requires specific training for the care-team. In fact, the progression of the disease, with the decline of physical--and sometimes cognitive--function, the increasing difficulties in speaking, breathing, and swallowing and the need of invasive choices, as the artificial nutrition and tracheostomy, constitute a challenge for the health professionals, often generating distress. For this reason, their cohesion and sharing abilities are fundamental...
April 2016: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
Wolfgang Buchenau, Sarah Wenzel, Margit Bacher, Silvia Müller-Hagedorn, Joerg Arand, Christian F Poets
BACKGROUND: Robin sequence (RS), characterised by micrognathia/retrognathia and glossoptosis with or without cleft palate, presents with intermittent upper airway obstruction and feeding difficulties. Active intervention is required to reduce the risk of brain damage or sudden death. Most treatment options are poorly studied and/or invasive. Our group developed a functional approach including early feeding training and the pre-epiglottic baton plate (PEBP), an orthodontic appliance with a velar extension shifting the base of the tongue forward...
July 19, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Robin S Howard
PURPOSE OF REVIEW: Understanding the mechanisms and abnormalities of respiratory function in neuromuscular disease is critical to supporting the patient and maintaining ventilation in the face of acute or chronic progressive impairment. RECENT FINDINGS: Retrospective clinical studies reviewing the care of patients with Guillain-Barré syndrome and myasthenia have shown a disturbingly high mortality following step-down from intensive care. This implies high dependency and rehabilitation management is failing despite evidence that delayed improvement can occur with long-term care...
October 2016: Current Opinion in Neurology
Yoshihiko Kumai, Yasuhiro Samejima, Masayuki Watanabe, Eiji Yumoto
: To determine the factors inducing aspiration following esophagectomy with three-field lymph node dissection (3FL) and the effect of the chin-down maneuver combined with supraglottic swallow (CDSS). Retrospective analysis of a consecutive case series. Videofluoroscopic (VF) evaluations of 25 patients who consulted with our out-patient clinic from 2006 to 2012 for swallowing dysfunction following esophagectomy with 3FL without tracheostomy were reviewed. The penetration aspiration scale (PAS) was used for evaluation...
July 16, 2016: European Archives of Oto-rhino-laryngology
Erica Everitt
The National Confidential Enquiry into Patient Outcome and Death in 2014 concluded that tracheostomy care fell below what is safe and reasonable to expect, and that staff needed training in this essential skill. This article, the first of a four-part series on all aspects of tracheostomy management, discusses the principles of tracheostomy care.
May 11, 2016: Nursing Times
L Paton, T Monro-Somerville, A Gibson, L Gemmell
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Gavriel D Kohlberg, Ya'akov Kobi Gal, Anil K Lalwani
OBJECTIVES: Loss of speech following tracheostomy and laryngectomy severely limits communication to simple gestures and facial expressions that are largely ineffective. To facilitate communication in these patients, we seek to develop a low-cost, noninvasive, portable, and simple visual speech recognition program (VSRP) to convert articulatory facial movements into speech. METHODS: A Microsoft Kinect-based VSRP was developed to capture spatial coordinates of lip movements and translate them into speech...
September 2016: Annals of Otology, Rhinology, and Laryngology
Maria Colandrea, Patricia Eckardt
BACKGROUND: The complication rates for tracheostomy patients could be serious and life threatening. As a result, length of stay (LOS) increases and patient outcomes can be negatively impacted. Examples of complications include accidental decannulation, bleeding and total occlusion. Studies suggest there is an inconsistency in tracheostomy care among providers and institutions. Other studies suggest stronger patient outcomes can result from improved staff training and appropriate protocols...
2016: ORL-head and Neck Nursing: Official Journal of the Society of Otorhinolaryngology and Head-Neck Nurses
Janet McDonald, Eileen McKinlay, Sally Keeling, William Levack
AIMS: To describe the learning process of family carers who manage technical health procedures (such as enteral tube feeding, intravenous therapy, dialysis or tracheostomy care) at home. BACKGROUND: Increasingly, complex procedures are being undertaken at home but little attention has been paid to the experiences of family carers who manage such procedures. DESIGN: Grounded theory, following Charmaz's constructivist approach. METHODS: Interviews with 26 family carers who managed technical health procedures and 15 health professionals who taught carers such procedures...
September 2016: Journal of Advanced Nursing
Ilse Groenendijk, Jane Booth, Monique van Dijk, Andrew Argent, Marco Zampoli
BACKGROUND: Children discharged home with a tracheostomy need a safe home environment and access to health care. We described the indications, clinical characteristics, socio-economic circumstances and outcomes of children enroled in a tracheostomy home care programme in South Africa. METHODS: We performed a retrospective chart review of children receiving a tracheostomy and enroled in the Breatheasy programme at the Red Cross War Memorial Children's Hospital, Cape Town...
May 2016: International Journal of Pediatric Otorhinolaryngology
Kevin Mary Callans, Carolyn Bleiler, Jane Flanagan, Diane L Carroll
UNLABELLED: The purpose of this qualitative study was to describe the family experience of caring for their child with a tracheostomy due to a compromised airway during the transition from hospital to home, and to identify types of support that families request to be successful caregivers. DESIGN AND METHODS: This study used a qualitative descriptive design with focus groups to answer semi-structured interview questions. The investigators followed basic content analysis to interpret descriptive data using three-person consensus...
July 2016: Journal of Pediatric Nursing
Amit Agarwal, Nancy Marks, Valerie Wessel, Denise Willis, Shasha Bai, Xinyu Tang, Wendy L Ward, Dennis E Schellhase, John L Carroll
OBJECTIVE: The results from a recent national survey about catastrophic complications following tracheostomy revealed that the majority of events involved a loss of airway. Most of the events due to airway loss involved potentially correctable deficits in caregiver education. Training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the knowledge and confidence level of pediatric health care providers at a large tertiary care children's hospital in routine and emergency tracheostomy care and evaluated the efficacy of a comprehensive simulation-based tracheostomy educational program...
July 2016: Pediatric Pulmonology
Angela Jerath, Niall D Ferguson, Andrew Steel, Duminda Wijeysundera, John Macdonald, Marcin Wasowicz
BACKGROUND: Sedatives are administered to 85% of intensive care unit (ICU) patients. The most commonly used sedatives are intravenous benzodiazepines and propofol. These agents are associated with over-sedation in 40 to 60% of patients, which can lead to prolonged intubation, delirium and drug-induced hypotension. Evidence is increasing that volatile anesthetic agents are associated with faster extubation times, improved cardiovascular stability with no end-organ toxicity in comparison to our standard intravenous agents for short-term critical care sedation...
2015: Trials
Kristi McGowin
Providing a child with a tracheostomy is often a life saving intervention. However, the impact on the family is frequently life changing. Parents of children with tracheostomies require specialized training in order to provide safe care for their child in the home setting. The purpose of this project was to investigate the outcomes of a parent education program delivered by a nurse practitioner and its impact on patient follow up for children with tracheostomies living at home. This quasi-experimental evidenced based project was based on an intervention group of five parent-child dyads and a control group of 23 parent-child dyads...
2015: ORL-head and Neck Nursing: Official Journal of the Society of Otorhinolaryngology and Head-Neck Nurses
Michael E McCormick, Erin Ward, David W Roberson, Rahul K Shah, Robert J Stachler, Michael J Brenner
OBJECTIVE: To report patient/family experiences and outcomes after tracheostomy STUDY DESIGN: International survey of patients and families with tracheostomy. SETTING: Collaboration of the Patient Safety and Quality Improvement Committee of the American Academy of Otolaryngology-Head and Neck Surgery and the Global Tracheostomy Collaborative. METHODS: A 50-item survey was developed with multistakeholder collaboration...
December 2015: Otolaryngology—Head and Neck Surgery
Janet McDonald, Eileen McKinlay, Sally Keeling, William Levack
OBJECTIVES: To explore the experiences of family carers who manage technical health procedures at home and describe their learning process. DESIGN: A qualitative study using grounded theory. PARTICIPANTS: New Zealand family carers (21 women, 5 men) who managed technical health procedures such as enteral feeding, peritoneal dialysis, tracheostomy care, a central venous line or urinary catheter. In addition, 15 health professionals involved in teaching carers were interviewed...
2015: BMJ Open
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