Tracheostomy Infections, Coursework Example

Introduction

Trachestomy infections are a potential risk associated with this practice, which is used when patients require mechanical ventilation (Sole et.al, 2014). The most common type of infection is a respiratory infection, which frequently occur in the form of ventilator-associated pneumonia (Sole et.al, 2014). In accordance with prior evidence in this area, critical factors include the timing of the procedure and the technical apparatus that is used for the procedure (Freeman & Morris, 2012). In addition, it is known that the procedure when performed using percutaneous dilation is safer and more cost effective than a traditional surgical approach (Freeman & Morris, 2012). In general, the use of the tracheostomy procedure should not be conducted until it is confirmed that the use of the ventilator will be required on a more long-term basis, and once this is determined, the aforementioned approach is recommended for use in many cases (Freeman & Morris, 2012).

Body

Upon examination of the Clinical Consensus Statement regarding tracheostomy, it is recommended that methods and approaches to the procedure should be streamlined in order to promote greater success with its use (Mitchell et.al, 2012). As mentioned previously, the timing of the procedure is of critical importance and requires expert knowledge in order to determine the best possible choice for a given patient (Gomes Silva, Andriolo, Saconato, Atallah, & Valente, 2012). This reflects the importance of understanding the nature and severity of the procedure, its potential complications, and its impact on quality of life for patients (Mitchell et.al, 2012). An understanding of percutaneous tracheostomy, for example, is required in order to support its widespread use, emphasizing the use of six separate procedures and the safest approach, known as single-step dilation in order to promote the best possible safety with this procedure (Cabrini et.al, 2012). With a consistent risk of respiratory infection, it is important to optimize the safety of the procedure and to consistently monitor patients for possible infection risk as best as possible (Bentley, 2012). Therefore, nurses must monitor patients on a frequent basis for possible signs of infection and other risks that are likely to occur (Bentley, 2012).

Administering care for a patient who requires a tracheostomy demonstrates the importance of proper care following the procedure that will aim to minimize infection risk as much as possible (Dawson, 2014). Therefore, understanding the procedure, the apparatus that is used, potential complications, and treatment alternatives is critical in order to be successful in treating the affected area effectively (Dawson, 2014). Procedures that must be implemented to reduce infection risk include mobilizing secretions by using a suction catheter, including the appropriate apparatus and supplies are available at the bedside (Morris, Whitmer, & McIntosh, 2013). This reflects a need to better understand the potential risks and complications of the tracheostomy procedure, such as infection, tracheomalacia, and the breakdown of skin in the affected area (Morris et.al, 2013). Therefore, nurses must be properly prepared to manage the risks associated with infection by developing protocols and procedures that will mitigate these risks in the intensive care unit, and this requires proper training and guidance in these areas in order to prevent the possible risk of infection and other complications for these patients (Morris et.al, 2013).

One option to consider based upon prior evidence is to implement a specialist with expert knowledge of the tracheostomy procedure and its complications in order to promote the appropriate care plan for a patient who requires respiratory support (Sodhi, Shrivastava, & Singla, 2014). It is important for nurses to be properly informed regarding this practice and to have an expert onsite who is skilled in this area in order to address any questions and concerns that may arise from the plan of care (Sodhi et.al, 2014). This process is also likely to reduce length of hospital stay and potential readmissions in the future; as a result, the integration of a specialist is desirable to address the outcomes of this procedure and to minimize risks (Sodhi et.al, 2014). The tracheostomy procedure must also be conducted with the safety and best interests of the patient in mind, using prior evidence to make decisions regarding the patient’s health status to ensure that the appropriate procedure is conducted (Lissauer, 2013). It is necessary for healthcare providers to discuss each case individually in order to identify a patient’s needs and the overall direction of the case to ensure that patient safety is not compromised (Lissauer, 2013). The development of a successful framework to accomplish the intended objectives for patients who require a tracheostomy is integral to the success of this procedure and the overall needs of this population; therefore, safety measures must be considered and plans of care that will be most suitable to meet a patient’s needs effectively (Lissauer, 2013).

Conclusion

The tracheostomy procedure introduces many challenges for healthcare providers with respect to infection risk and other complications; therefore, it is necessary to develop strategies that will encompass successful outcomes for patients and promote an environment where care and treatment are of the highest possible quality. It is important for nurses to utilize specialized expertise in this area whenever possible and to make decisions that will have the patient’s best interests in mind. This also reflects the importance of identifying an environment where patient care is supported by knowledge of the different types of tracheostomy procedures and protocols to make decisions that will promote patient safety at all costs. There must be a greater emphasis on reducing infection risk for patients who require tracheostomies and to improve patient outcomes as best as possible.

References

Bentley, A. (2012). Tracheostomy: Management. PACEsetterS, 9(1), 20-22.

Cabrini, L., Monti, G., Landoni, G., Biondi?Zoccai, G., Boroli, F., Mamo, D., … & Zangrillo, A. (2012). Percutaneous tracheostomy, a systematic review.Acta anaesthesiologica Scandinavica, 56(3), 270-281.

Dawson, D. (2014). Essential principles: tracheostomy care in the adult patient.Nursing in critical care, 19(2), 63-72.

Freeman, B. D., & Morris, P. E. (2012). Tracheostomy practice in adults with acute respiratory failure. Critical care medicine, 40(10), 2890-2896.

Gomes Silva, B. N., Andriolo, R. B., Saconato, H., Atallah, Á. N., & Valente, O. (2012). Early versus late tracheostomy for critically ill patients. The Cochrane Library.

Lissauer, M. E. (2013). Benefit, timing, and technique of tracheostomy. Current problems in surgery, 50(10), 494-499.

Mitchell, R. B., Hussey, H. M., Setzen, G., Jacobs, I. N., Nussenbaum, B., Dawson, C., … & Merati, A. (2012). Clinical consensus statement tracheostomy care. Otolaryngology–Head and Neck Surgery, 0194599812460376.

Morris, L. L., Whitmer, A., & McIntosh, E. (2013). Tracheostomy care and complications in the intensive care unit. Critical care nurse, 33(5), 18-30.

Sodhi, K., Shrivastava, A., & Singla, M. K. (2014). Implications of dedicated tracheostomy care nurse program on outcomes. Journal of anesthesia, 28(3), 374-380.

Sole, M. L., Talbert, S., Penoyer, D. A., Bennett, M., Sokol, S., & Wilson, J. (2014). Comparison of Respiratory Infections before and after Percutaneous Tracheostomy. American Journal of Critical Care, 23(6), e80-e87.