Standardizing Tracheostomy Discharge Education Using an Interdisciplinary Hand-off Form: A Quality Improvement Study

Adults discharged home with a tracheostomy face preventable risks of tube dislodgement, obstruction, infection, and delayed emergency response. Consistent discharge education and interdisciplinary communication can support safe transitions from hospital to home.

On an adult surgical telemetry unit at an academic medical center, tracheostomy discharge education and documentation were inconsistent across the electronic health record. Variable handoff practices between registered nurses and respiratory therapists contributed to fragmented care.

This quality improvement project used a prospective pretest-posttest design guided by a knowledge translation framework. Registered nurses and respiratory therapists received education on a standardized tracheostomy discharge handoff form. Anonymous electronic surveys assessed perceived understanding of discharge education, interdisciplinary communication, and tool satisfaction at baseline and after 12-weeks. Responses were analyzed using the Wilcoxon signed rank test.

An interdisciplinary handoff form outlining key tracheostomy education domains was initiated on admission and kept at the bedside. The form supported sequential instruction, demonstration, and return demonstration, with clinician sign-off, and was uploaded to the electronic medical record at discharge.

Eighteen nurses and six respiratory therapists completed baseline surveys; nine nurses completed paired surveys. Understanding scores were high at baseline with no significant post-intervention change. Perceived interdisciplinary communication improved, and two-thirds of nurses reported satisfaction with continued use. No respiratory therapists completed post-intervention surveys.

A standardized tracheostomy discharge handoff form was feasible to implement and was associated with improved perceived communication and nurse satisfaction. Integration into the electronic medical record and inclusion of patient-reported outcomes warrant further study.