Multidisciplinary care for tracheostomy patients: a systematic review

Area of Science:

• Medical care
• Patient outcomes
• Hospital management

Background:

• Tracheostomy care is crucial for over 7000 patients annually in Australia and New Zealand.
• Patients often transfer from intensive care units (ICUs) to general wards post-tracheostomy.
• Inadequate staff skills can lead to suboptimal care and increased patient morbidity.

Purpose of the Study:

• To determine if multidisciplinary tracheostomy outreach teams reduce time to decannulation.
• To assess if these teams decrease length of stay in acute and sub-acute settings.
• To evaluate improvements in quality of care and reduction of adverse events for tracheostomy patients.

Main Methods:

• Systematic review of relevant English-language trials.
• Searches conducted in Medline, CINAHL, All EBM, and EMBASE databases in June 2009.
• Studies selected and appraised by two reviewers with established criteria.

Main Results:

• Three cohort studies with historical controls met inclusion criteria.
• All studies included adult patients with tracheostomies.
• Multidisciplinary care reduced average time to decannulation and length of hospital stay post-ICU discharge.

Conclusions:

• Multidisciplinary teams showed reductions in time to decannulation, length of stay, and adverse events for tracheostomy patients.
• Impacts on overall quality of care were not reported.
• Results require cautious interpretation due to methodological weaknesses in the included studies.