Care and Suctioning:An Evidence-Based Perspective
C. St. Clair, RN, BSN
Clinical staff Nurse
Walter Reed Army Medical Center
level and variation in practice of tracheostomy care and
suctioning of inpatients were identified at one military
medical center. These inconsistencies can lead to nosocomial
infections, prolonged hospitalizations, airway complications
A literature review
of tracheostomy care was completed using online search engines
such as MEDLINE, CINAHL, the Cochrane collagoration, Medscape,
AACN practice guidelines, and the Joanna Briggs Institute.
Pertinent articles were identified, then evaluated by two
independent reviewers and graded for the level of evidence.
Using the hospital's existing
Performance Improvement model (FOCUS-PDCA,) an interdisciplinary
team developed practice guidelines for tracheostomy care
at this facility.
the change, an evidence-based competency program (or tool)
will be developed. Using an interdisciplinary approach,
education and monitoring will take place for all staff involved
with tracheostomy care.
Baseline and post-implementation
indicators for this project will include practice variation,
procedural supplies, technique, frequency, technical knowledge
of tracheostomy care, patient satisfaction and comfort,
and complication rates. Implementation of the guideline
is projected for June 2003.
existing quality improvement model can be adapted to implement
evidence-based guidelines. This is the first project undertaken
in a new Evidence-Based Nursing Performance Improvement
Program at this facility.
Stevens, K.R. (2002). ACE Star Model of EBP: The Cycle
of Knowledge Transformation. Academic Center for Evidence-based
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