PURPOSE: Tracheostomy is a commonly performed procedure on critically ill patients. Many of these patients leave the intensive care unit with their tracheostomy in place and are then cared for by medical practitioners who do not perform the procedure or deal with its complications on a regular basis. It is important that all such practitioners be able to identify tracheostomy complications and treat them appropriately.
METHODS: A survey containing 12 demographic and 9 knowledge based questions regarding treatment of tracheostomy complications was distributed to a variety of different medical and surgical practitioners across the United States.
RESULTS: 474 health care practitioners responded to the survey (52% residents, 9% fellows, 35% attendings, 3% nurses, 1% Nurse Practitioner/Physician Assistant). The classification of respondents according to specialty was as follows: 36% surgery, 16% anesthesia, 15% emergency medicine, 13% critical care, 7% internal medicine, 1% nursing, 12% other. The mean knowledge score for the entire population was a 3.98 out of 9. Fellows and attendings performed significantly better than residents and nurses. Increasing Resident/Fellow training level was associated with an increase in score, but years of attending experience showed no difference. Surgeons overall had the best mean score, 4.46 (p= 0.002). Those who had formal tracheostomy training did not perform better than those who never received such education. Those who perform tracheostomy had significantly higher scores than those who do not(p=0.015).
CONCLUSION: Practitioner knowledge regarding management of tracheostomy complications is poor. Formal education regarding such complications and their management should be required for all practitioners caring for these patients.
CLINICAL IMPLICATIONS: More in-depth education with regard to tracheostomy education is needed to ensure adequate patient care.
DISCLOSURE: Talia Ben-Jacob, No Financial Disclosure Information; No Product/Research Disclosure Information