An Interprofessional Approach: Prevention of Tracheostomy Related Pressure Injury

Purpose: To determine if a standard tracheostomy care protocol using a fenestrated foam dressing and neutralizing the head position would decrease the incidence of hospital acquired tracheostomy related pressure injury. 

Methods:  An interprofessional committee was created and came to consensus to standardize care for individuals with a tracheostomy.  Interprofessional education was provided for this standardized care using infographics, tracheostomy care guidelines, daily huddles, and bedside rounding.  Staff attestation was collected.  Direct observation and data collection of the following was performed: presence of foam dressing (y/n), pressure injury (y/n), neutral head position (y/n), and suture removal by day 7 for new tracheostomies (y/n).

Results:  Education was provided for surgeons, registered nurses, ancillary personnel and respiratory therapists.  One hundred percent adherence to the protocol has been observed and no new pressure injuries have been documented since initiation of the standard protocol.

Discussion: To prevent tracheostomy pressure injury a comprehensive tracheotomy care protocol was developed with expert advice from the interprofessional team. Coordination and collaboration were necessary for the information to be communicated, distributed and implemented to all the involved departments and staff for 100% compliance.

Implications for practice:   A standardized approach of placing a fenestrated foam dressing and neutralizing the head position for patients with tracheostomies may result in reducing hospital acquired tracheostomy related pressure injury.