1. Patient/Community Education Process

2.  April 2014 - United Regional joined the Global Trach Collaborative  Purpose: To ensure tracheostomy care is coordinated and standardized across the system and out into the community.  Tracheostomy care is high risk with significant morbidity and mortality.

3.  Timeline for GTC was 12 months  Our goals were to develop P&P, trach rounding team, and an education plan.  We began rounding onevery trach patient at URHCS patients in October 2014.  Pts are seen 2 x week. The team includes:  Physician  RT  Educator  SLP  Social Services/Case Management.  Once P&P was completed at the end of 2014 we were able to develop our education plan for patients and staff.

4.  Mosbys On-line Education System  Trach care and Suctioning modules for all staff  New Hire Trach Care Education & Skills Check Off  Information made available on units  Flash Rounds  During the month of April, flash rounds on all nursing units to demonstrate trach care

5.  Initiated on Adult Trach Admission order set.  Mosby’s Nursing Consult Patient Education  English & Spanish materials available  TIGR TV & Educational Videos  Education Home DVD at discharge  All education is documented in the electronic record and sent to the Patient Education Log.  Education of patients and caregivers is initiated by RT and reinforced by nursing staff.

6.  All patients/caregivers going home demonstrate the ability to care for their trach for 24hrs prior to discharge by being checked off on the following:  Knowledge of supplies & equipment to include:  trach tube/obturator  inner cannula  suction cath/yankeur  trach dressing  Suctioning trach  Change/clean inner cannula and trach ties  Decannulation

7.  All patient rooms are set up to include suction, humidifier, ambu bag, and a cuff manometer  Every trach patient receives a trach kit containing standard supplies to including:  Suction catheter  Yankeur  10 ml leur lock syringe  trach dressings  Sterile H2O & H2O2  2 extra trach tubes (1 the same size and 1 a size smaller.)  The trach kit is kept stocked and follows the patient throughout the system and at discharge

8.  HOB signs posted include date trach inserted, type and size. The trach obturator is taped to the sign for easy access in an emergency.

9. URHCS participates in the GTC tracheostomy database which allows us to:  track tracheostomy care  benchmark with other centers  monitor adverse events & track changes in outcomes as we implement interventions.

10.  Audit compliance with protocols  Regularly review data and revise processes based on outcomes  Continue to expand upon best practices and share our findings