Authors (including presenting author) :
Pang JYK (1)(3), Ma NC(1)(3), Pang CT(1)(3), Yau SC (2)(3), Po LY (2)(3), Kwok MW(1)(3), Ng PF (1)(3), Ting HY(1)(3) and Ng KK(2)(3)
Affiliation :
(1) Registered Nurse, (2) Enrolled Nurse, (3) Surgery, Tung Wah Hospital Special Acknowledgement to Ms. Karen Cheng, WM(SRG)TWH, Ms. Alice Tong, WM(SRG)TWH and Ms. Lam SC, DOM(SRG)TWH in this study
Introduction :
Tracheostomy is used to sustain patient ‘s airway when the upper airway is occluded. It can be either temporary or permanent nature depending on the type of disease. Double cannula tracheostomy tube is commonly used in hospital. The usual practice is adopted by the use of hydrogen peroxide (H2O2) as supplied by pharmacy. However, starting from 3rd Nov. 2019, there would have no more supply of H2O2 solution from pharmacy. Hospital Quality & Safety Team (Q&S) suggested us to use sterile saline or sterile water instead. This study was to explore the difference between the two lotions.
Objectives :
To explore the difference of using sterile saline and sterile water in cleansing the tracheostomy tube.
Methodology :
It was an exploratory comparative study performed in the clinical ward setting using convenience sampling. 16 supporting staff were invited for an interview in two different groups of staff working at two different wards on 4-12/11/2019 and 25/11-8/12/2019 in a private setting without interruption. A well designed questionnaire with expert validation was applied. They followed strictly to the standard cleansing procedure.
Result & Outcome :
The first group staff expressed no difference between the use of sterile saline and sterile water in cleansing the tracheostomy tube. Only one out of eight candidates expressed using sterile saline was better. All of the staff expressed their preference of using H2O2 which was the best for cleansing. Further exploration on using the sterile water in the second group, seven out of eight staff expressed no difficulties to remove the debris in the tracheostomy tube but at least soaking for 30 minutes or more. Therefore time control on the soaking, flushing and temperature used may affect the results. Despite our samples were relatively small by involving all supporting staff working in C6 & C7 ward, the cleansing process was not particularly difficult for them. The project was largely successful by motivating staff to carry out the continuous quality improvement in an exploratory comparative method. As a conclusion, the study demonstrated no difference between the use of sterile saline or sterile water. There are typical concerns on time control of soaking, flushing and temperature that needed further investigation.
