Standardized management of subglottic suctioning in adult tracheotomy patients in a chinese tertiary hospital: a best practice implementation project

INTRODUCTION: Subglottic secretion suctioning is an effective measure for reducing aspiration pneumonia and is recommended as a crucial step in artificial airway management for tracheotomy patients. However, this method remains undervalued, and clinical practice is not always evidence-based. OBJECTIVE: This project aimed to promote compliance with best practices for subglottic suctioning in adult tracheotomy patients in the Rehabilitation Department of a 3,000-bed tertiary hospital in China. METHODS: This project was guided by the JBI Evidence Implementation Framework, which includes the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) methods. Evidence-based audit criteria were developed for the baseline and follow-up audits. A total of 168 tracheotomy patients took part in the audits. After the implementation of improvement strategies, a follow-up audit was conducted to measure changes in compliance. RESULTS: The follow-up results showed improvement in three criteria compared with baseline. For Criterion 1, compliance increased by 17.85% (77.38% to 95.23%); for Criterion 2, compliance increased by 96.42% (0% to 96.42%); and for Criterion 3, compliance increased by 46.43% (53.57% to 100%). The difference in nurses' knowledge scores for subglottic suctioning between baseline and follow-up was statistically significant (all p < 0.05). Moreover, the rate of aspiration pneumonia, airway mucosal bleeding, and subglottic tube blockage decreased from 27.38%, 20.23%, and 30.95% before implementation to 14.28%, 5.95%, and 10.71%, respectively, (all p < 0.05). CONCLUSIONS: Evidence-based practices can improve nurses' knowledge of standardized subglottic suction management practices for tracheotomy. Further studies are needed to ensure the sustainability of the project. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A556.