Question

Katie is a nurse practitioner in otolaryngology head & neck surgery at a Midwest tertiary care facility. Her pt. population often requires an altered airway, including tracheostomy. Tracheostomy care is a frequently challenging nursing intervention with conflicting practice information. Tracheostomy care policies & procedures are often based on experience & expert opinion. Most recent research evidence is specific to pt populations that are intubated & differ from pts undergoing tracheostomy for head & neck surgery. One controversial example of practice variations is the instillation of saline before tracheal suctioning. Katie wants to take the lead in developing an EBP policy for tracheostomy care that is universal for pts with an altered airway due to tracheostomy. Please respond to the following questions:

1. What process does she follow for pursuing an evidenced-based standardized policy?

2. How can she determine if it is a priority for the organization?

3. Who are the stakeholders & potential team members?

4. Why is it important to involve the nurse manager?

5. How do you grad/score classic research studies & expert opinions?

6. After developing an evidence-base recommendation what are the key process & outcome indicators to measure?

Answer 1

1, Evidence-based practice she used for suctioning a trach tube,securing device, when to suction and its technique, liquefying secretion, dressing site.
2, To acheive positive outcome patient with tracheostomy tube,follow best practice and utilize the skills..The nurse must be familiar with organization policy and procedure about trach tube care..evidence based support when policies and procedures not support consider managers and seniors for different approaches to suctioning..
3, Stakeholder involvement in tracheostomy care includes family, physician, attending physician,nurse, social worker,case managers, inter-professional or inter-disciplinary tracheostomy team, physiotherapist, speech therapist and dietician..
4, Nurse managers will have extra skills and experience they are important in surgical ward and ICU to organize and the wider multidisciplinary team in future needs and care..They will also meet the unique needs of each patient safety and needs..