AARC Member Co-Authors Consensus Statement on Trach Care

October 9, 2012

AARC member Kathleen Deakins, MSHA, RRT-NPS, FAARC, is a co-author of a new clinical consensus statement on tracheostomy care. The paper has been published online ahead of print by Otolaryngology—Head and Neck Surgery and is expected to help guide tracheostomy care for adults and children.

Deakins got involved in the project a couple of years ago after the AARC was contacted for the name of a respiratory therapist who could serve on the consensus panel. She was recommended due to her long record of active involvement in respiratory care at Rainbow Babies & Children’s Hospital in Cleveland, OH, where she currently serves as clinical manager of woman’s and children’s respiratory care and pediatric pulmonary function and infant monitoring and has spearheaded numerous continuous quality improvement (CQI) efforts over the years.

Those efforts earned her the Sally Ann Shipley Award earlier this year, a newly established award given by her hospital group to honor those who have excelled in the area of CQI.

Deakins says she agreed to serve on the panel because she believed it would be a great opportunity to share the respiratory therapist’s expertise in the area of trach care. “Respiratory therapists spend a great deal of time at the bedside caring for these patients and work closely with the otolaryngologists in making recommendations for improvement in selection of trach sizes and emergency management,” she says. “They depend on us to help provide excellence in transitioning these patients to long-term care.”

According to Deakins, the consensus team was collaborative and open, and spoke very highly of all multidisciplinary roles and their involvement in caring for trach patients. “Respiratory therapists play an integral role in the day to day management of tracheostomy patients and are respected for their contribution and expertise.”

The group reached consensus on 77 statements pertaining to initial tracheostomy tube change, management of emergencies and complications, prerequisites for decannulation, management of tube cuffs and communication devices, and specific patient and caregiver education needs. The panel also highlighted 39 other areas where consensus could not be reached, paving the way for further study in those areas.

Deakins believes the statement will go a long way to improving the consistency of trach care provided in hospitals and urges her fellow RTs to share the document with the physicians they work with. That’s something she and her colleagues have already done at Rainbow Babies and Children’s.

“In discussing the results of this statement with the pulmonary physician colleagues at our hospital, we determined that the emphasis on pre-surgical education to patients and families is crucial and greater now more than ever,” she says.

She also noted that there are minimum expectations for the management of tracheostomy patients that must be met to provide safe and effective care and specifically cited the need to address equipment and emergency care needs, along with the need to take the differences in management of adult and pediatric trach patients into account. The latter, she says, are clearly outlined in the statement.

Deakins says serving on the consensus panel was an interesting experience and she was pleased to be able to bring the respiratory therapist’s perspective to the group. “Clarifying care practices is beneficial for streamlining health care,” she says. “The role that RTs play in the delivery and integration of health care is valued, and this consensus statement gives us another example of how we can contribute to excellence in providing a continuum of care.”