The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts


Amelia A. Lowell, Laura I. Chacon, Julie A. Colquist, Pamela J. Dorrell, Mary Jane Johnson, Lauren Kominowski, Kathleen Poquette, Tamara Zajicek; Respiratory Care, Mayo Clinic Hospital, Phoenix, AZ

Background: Patient safety can be impacted by a lack of equipment necessary to handle a dislodged/displaced trach. A lack of knowledge by the RT of required bedside tracheostomy supplies coupled with inconsistent bedside stocking of such supplies may result in decreased patient safety, inefficient use of the therapists’ time and increased cost to the hospital. Standard practice of the RT gathering supplies for the room varied with individual understanding of what should be present at the bedside. Constructing a standardized trach kit to be placed at the bedside was proposed as a solution to the problem. The sealed kits contain two sizes of ET tubes, suction catheters, #4,6,8 cuffed Shiley trachs, 10 ml syringe, lubrication and a trach tie. Total cost for the supplies in the kit was $134.00. Additionally, a manual resuscitator bag and O2 coupler are supplied with the kit. Upon patient discharge the kits are restocked and re-sealed per infection control policy. It was predicted that 100 percent compliance with kits at the bedside could be achieved in three months from the start date. The predicted results of the project: an increase in patient safety, a decrease in cost for lost “spare trachs”, and more efficient use of time by the therapist. Methods: The Plan, Do, Study, Act performance improvement process was used. Hospital wide education was provided to RT’s and RN’s prior to implementation of the supply kits. Kits were placed in a central location in the RT supply room. Pre-implementation data was collected over a four week period. Trach patients’ rooms were audited once a week using a checklist of supplies consistent with hospital policy. After the initial audits, a three week pilot using a trach supply kit was completed. All trach patient rooms were audited for compliance with the new kit. Results: 14 patients were audited pre-trial: 78% had a spare trach, 57% had suction catheters, 37% had a 10 ml syringe, and 64% had a manual resuscitator bag. Post trial 100% of patients had a trach kit and manual resuscitator bag. $6720 could be saved in “spare trachs” based on the average number of trach patients per year, allotting one spare trach per patient. Positive feedback was noted from RT’s, RN’s and MD’s. Conclusion: Constructing a standardized trach supply kit is an improvement for patient safety, as well as, a time and cost effective solution for providing consistent supplies at the bedside. Sponsored Research - None