Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/29918
Title: Tracheostomy clinical practices and patient outcomes in three tertiary metropolitan hospitals in Australia
Austin Authors: Zaga, Charissa J ;Berney, Sue;Hepworth, Graham;Cameron, Tanis S;Baker, Sonia;Giddings, Charles;Howard, Mark E;Bellomo, Rinaldo;Vogel, Adam P
Affiliation: Department of Speech Pathology, Division of Allied Health, Austin Health, Heidelberg, Victoria, Australia
Department of Audiology and Speech Pathology, School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
Department of Physiotherapy, Division of Allied Health, Austin Health, Heidelberg, Victoria, Australia
Department of Physiotherapy, School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
Institute of Breathing and Sleep, Austin Health, Victoria, Australia
Statistical Consulting Centre, The University of Melbourne, Victoria, Australia
Tracheostomy Review and Management Service, Allied Health Division, Austin Health, Heidelberg, Victoria, Australia
Department of Speech Pathology, Royal Brisbane and Women’s Hospital, Brisbane, Australia
Department of Ear, Nose and Throat Surgery, Monash Health, Melbourne, Australia
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Intensive Care, Austin Health, Melbourne, Australia
Department of Critical Care, University of Melbourne, Melbourne, Australia
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia
Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Australia
Department of Neurodegeneration, Hertie Institute for Clinical Brian Research, Tübingen, Germany
Redenlab, Mebourne, Australia
Issue Date: 2022
Publication information: Zaga CJ et al., Tracheostomy clinical practices and patient outcomes in three tertiary metropolitan hospitals in Australia, Australian Critical Care, https://doi.org/10.1016/j.aucc.2022.03.002
Abstract: Background There is a paucity of literature in Australia on patient-focused tracheostomy outcomes and process outcomes. Exploration of processes of care enables teams to identify and address existing barriers that may prevent earlier therapeutic interventions that could improve patient outcomes following critical care survival. Objectives The objectives of this study were to examine and provide baseline data and associations between tracheostomy clinical practices and patient outcomes across three large metropolitan hospitals. Methods We performed a retrospective multisite observational study in three tertiary metropolitan Australian health services who are members of the Global Tracheostomy Collaborative. Deidentified data were entered into the Global Tracheostomy Collaborative database from Jan 2016 to Dec 2019. Descriptive statistics were used for the reported outcomes of length of stay, mortality, tracheostomy-related adverse events and complications, tracheostomy insertion, airway, mechanical ventilation, communication, swallowing, nutrition, length of cannulation, and decannulation. Pearson’s correlation coefficient and one-way analyses of variance were performed to examine associations between variables. Results The total cohort was 380 patients. The in-hospital mortality of the study cohort was 13%. Overall median hospital length of stay was 46 days (interquartile range: 31-74). Length of cannulation was shorter in patients who did not experience any tracheostomy-related adverse events (p= 0.036) and who utilised nonverbal communication methods (p = 0.041). Few patients (8%) utilised verbal communication methods while mechanically ventilated, compared with 80% who utilised a one-way speaking valve while off the ventilator. Oral intake was commenced in 20% of patients prior to decannulation. Patient nutritional intake varied prior to and at the time of decannulation. Decannulation occurred in 83% of patients. Conclusions This study provides baseline data for tracheostomy outcomes across three large metropolitan Australian hospitals. Most outcomes were comparable with previous international and local studies. Future research is warranted to explore the impact of earlier nonverbal communication and interventions targeting the reduction in tracheostomy-related adverse events.
URI: https://ahro.austin.org.au/austinjspui/handle/1/29918
DOI: 10.1016/j.aucc.2022.03.002
Type: Journal Article
Appears in Collections:Journal articles

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