Authors

  1. Richardson, Janette MSN, RN, AGCNS-BC, CCRN
  2. Girardot, Kellie MSN, RN, AGCNS-BC
  3. Powers, Jan PhD, RN, CCNS, CCRN, NE-BC, FCCM, FAAN
  4. Kadenko-Monirian, Michele MSN, RN, ACCNS-AG, AGCNS-BC, CCRN, CNRN

Abstract

Background: Patients with a tracheostomy are a low-volume, high-risk population with long lengths of hospital stay and high health care costs.

 

Problem: Because of the complex nature of caring for patients with a tracheostomy, it is essential to provide a standardized care approach with ongoing monitoring to optimize outcomes.

 

Approach: A pre/postimplementation design was used. A formal tracheostomy care management process using clinical nurse specialists (CNSs) was implemented.

 

Outcomes: Between April 2019 and December 2020, this process resulted in a significant reduction in time between tracheostomy placement and discharge, from 16 to 12.9 days (P = .02). Reductions were also seen in length of stay and incidence of tracheostomy-related pressure injuries.

 

Conclusions: This project shows that a CNS-led care management process can improve patient outcomes. These improvements in patient outcomes resulted in a significant cost savings to the organization.