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Tracheostomy Thursday: Journey of a Staff-driven COVID-19 Initiative to International Recognition
Mary Anne Gallagher1, Lisa Anne Torrieri
1At NewYork-Presbyterian Hospital, New York, NY, Mary Anne Gallagher, DNP, RN, Ped-BC, is Director of Nursing, Center for Professional Nursing Practice, and Lisa Anne Torrieri, MSN, RN, FNP, CWON, is Nurse Clinician. Acknowledgments: The authors thank Rosanne Raso, DNP, RN, NEA-BC, FAAN, FAONL, CNO, NewYork-Presbyterian/Weill Cornell for her leadership, advocacy, and support of frontline nurses and interprofessional collaboration; MariLou Prado-Inzerillo, DNP, RN, NEA-BC, Vice President of Nursing Operations, NewYork-Presbyterian for her leadership and support of frontline staff recognition; the Tracheostomy Thursday team for their professionalism, exemplary care, collaboration, and outcomes and for putting patients first in the epicenter of a pandemic; and Sigma nursing for providing the opportunity to recognize excellence in nursing. The authors have disclosed no financial relationships related to this article. Submitted to Nursing Management March 29, 2022; accepted in revised form June 10, 2022. This article is jointly published in Nursing Management as Gallagher MA, Torrieri LA. Tracheostomy Thursday: journey of a staff-driven COVID-19 initiative to international recognition. Nurs Manage 2022;53(9).
Objective:
To use evidence-based practice and an interprofessional approach to improve outcomes for adult patients with tracheostomies and enhance staff knowledge during the COVID-19 pandemic.
Methods:
The core interprofessional Tracheostomy Thursday team included staff nurses, respiratory therapists, and nursing leadership who collaborated with surgeons and materials management staff at an urban academic medical center in New York, the epicenter of the COVID-19 pandemic in the US. The team implemented hospital-wide bedside rounds on all adults with tracheostomies. Skin and safety assessments were performed with peer-to-peer coaching. Data were collected and analyzed to understand areas of improvement.
Results:
After 6 months of hospital-wide rounding, implementation of a bedside tracheostomy safety checklist, and a continued interprofessional approach, safety measures increased by 48%, and preventive dressing use increased by 24% with improvement in preventing tracheostomy-related medical device-related pressure injuries. The team's work was professionally recognized through institutional policy change, conference poster presentations, and Sigma's international excellence award.
Conclusion:
Bundling an interprofessional approach, staff education, bedside rounds, and standard preventive measures was key to the team's success. A bedside safety checklist fostered team communication and supported direct care nurses in managing individuals with a new tracheostomy.
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