A Descriptive Observational Study of the McGill University Health Centre Capping Trial Protocol in Facilitating Tracheostomy Decannulation

Background Tracheostomy decannulation improves patient quality of life and reduces healthcare costs. At the McGill University Health Centre (MUHC), a protocol was developed in 2016 to standardize care for adult patients with tracheostomies, preventing complications related to capping techniques. Though based on clinical expertise and evidence, this protocol has not been formally evaluated. This study aimed to assess this protocol in facilitating decannulation. Methods A descriptive observational study was conducted with 44 adult patients who had a tracheostomy tube and were assessed by the tracheostomy team for capping trial eligibility. Patients were placed on a structured protocol, involving set timeframes (e.g., 12 or 24 hour capping periods) on specific days. Patients were monitored for respiratory distress, secretion management, and overall tolerance. Data were collected from patient medical records; variables included age, anxiety levels (using the Spielberger State-Trait Anxiety Inventory (STAI-6) questionnaire), and level of consciousness (Glasgow Coma Scale (GCS)). Patients were categorized as “successfully decannulated” or “not successfully decannulated” based on their trial outcomes. Results Of the 44 patients, 39 (89%) were successfully decannulated within the set timeframe. Among the 39 successful cases, the majority (87%) required only one trial capping attempt. There was no significant difference in age (p=0.494) or anxiety levels (p=0.588) between the two groups. However, a significant difference (p=0.002) was found in GCS scores, with patients who were successfully decannulated having a higher mean GCS score 14.7 (SD= 1.01) compared to those who were not decannulated (mean = 12.6, SD = 3.29). Conclusions The MUHC capping trial protocol demonstrates a high success rate for tracheostomy decannulation, with most patients requiring only one trial attempt. While age and anxiety were not significant, a higher Glasgow Coma Scale score was associated with better outcomes. Further research is needed to explore additional influencing factors and long-term outcomes.