CQI Project on Enhancement of Practice for Routine Care of Double Cannula Tracheostomy Tube in Department of Surgery, TWH

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Abstract Description
Abstract ID :
HAC6354
Submission Type
Authors (including presenting author) :
Tong ASY(1)
Affiliation :
(1)Department of Surgery, Tung Wah Hospital
Objectives :
This project aimed to ensure patient safety and quality of care via enhancement of the practice of routine care of double cannula tracheostomy tube at Department of Surgery, TWH. It also aimed to develop a standard of practice for staff guidance and standardize the procedure of routine care of double cannula tracheostomy tube to ensure consistent practice at Department of Surgery, TWH.
Methodology :
Target population was all nursing staff performing clinical duties in clinical in-patient areas namely wards C4, C6, C7 & SCU. All nursing staff were required to perform compliance assessment on routine care of double cannula tracheostomy tube as baseline assessment from September 2020 to January 2021. Instrument used A structured compliance assessment form consisting of a total of 9 parts with 38 steps in the routine care procedure was designed with experts’ validation. The procedure of routine care of double cannula tracheostomy tube was developed with experts’ validation. Data Collection All nursing staff were assessed by recognized assessors in department on one-to-one basis at bedside using the designed compliance assessment form and staff performed the procedure of routine care of double cannula tracheostomy tube without interruption. Convenience sampling was used for patient selection. Each procedure lasted for about 30 minutes under direct observation by the assessor.
Result & Outcome :
1. The Standard of Practice for Routine Care of Double Cannula Tracheostomy Tube in Department of Surgery was developed(Document No.: TWH-SRG-PD-SRG-002-v01). 2. The standardized procedure of routine care of double cannula tracheostomy tube was designed. 3. Result of Compliance Assessment: Compliance Rate for all staff: 95% or above.
Calculation Marks Attained by Staff = Marks Attained/ 38 Compliance Rate of Staff = Marks Attained/ 38 x 100% Total 73 nursing staff from 4 in-patient wards in Department of Surgery completed the compliance assessment on routine care of double cannula tracheostomy care. The nursing staff ranks were APN, RN & EN who all worked in ward areas. They all followed strictly to the steps in the procedure of routine care and 60 of them scored 100% and 10 of them scored 97.4%, and 3 of them scored 94.7%. The deducted marks were all deducted from non-critical steps. Only one staff failed during first attempt and she achieved 100% compliance rate upon second attempt. The compliance rates of individual wards were 98.2%, 99.8%, 100% & 99.4%. The overall compliance rate in the Department of Surgery, TWH was 99.4% which was higher than the aimed compliance rate.

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