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'Tracheostomy training is vital for nursing staff'


About half of deaths in patients with a tracheostomy occur as a result of displacement or dislodgement of the tube.

However, a national enquiry has found there is no mandatory training for staff on this care issue, with around a quarter of hospitals not offering any training on how to manage displacement or dislodgement. These patients begin their care pathway in critical care but will also be cared for on general wards and in the community as they progress.

This week we have the first article in our four-part series on caring for patients with a tracheostomy, which details the main principles of care to keep these patients safe. Subsequent articles in the series will discuss how to care for a temporary or permanent tracheostomy and caring for people with a laryngectomy.

Kathryn Godfrey is practice and learning editor of Nursing Times. Twitter @GodfreyKathryn

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Readers' comments (2)

  • phew..and many nursing homes are taking these patients on without training prior to admission...

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  • James Lynch

    Training is available from a number of outlets. eLfH, and BACCN both provide online modules. ALSG, ENT UK and others provide hands on courses whilst NTSP resources are freely available to 'build your own'. A search for community specific resources would be less fruitful.
    The problem, in my experience, is devising the correct model of training and having the organisational structure to maintain it. Training staff is simple enough, but what do you do if they don't look after a tracheostomy patient for 2 years? Training also needs to be multidisciplinary. If a competent nurse identifies the tube as blocked that's great. If the secondary responders then fail to spot the tube is in a laryngectomy rather than a tracheostomy, outcomes won't improve.
    There are a lot of things to consider if revising tracheostomy care training, pathways and policies at a trust and a collaborative approach is needed. At my trust we have found the global tracheostomy collaborative helpful.
    Lastly, in my experience, revision of policy/training at a trust tends to be reactive, usually following a tracheostomy disaster. Even most of the afore mentioned resources were born on the back of un-necessary incidents/deaths. As I saw it, the key recommendation from NCEPOD was to get proactive with trachy care. 2 years on, have things changed significantly?

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