Nursing Skills in the Care of Patients With Respiratory Stomas in Hospitals With and Without Advanced Practice Tracheostomy Service

ABSTRACT

Aims

To identify whether there are differences in knowledge regarding the management of patients with respiratory stomas among nurses working in hospitals with an advanced practice tracheostomy service compared to those without it.

Design

Descriptive, cross-sectional, comparative, analytical survey study.

Method

The study was conducted from January to March 2023 in four tertiary care hospitals, two of which have an advanced practice tracheostomy service. A self-administered questionnaire was designed, consisting of 16 questions about nurses' specialised training in caring for tracheostomy patients. The study adhered to the STROBE checklist. Statistical analyses were performed using SPSS (24.0) from IBM.

Results

Nurses in hospitals with a dedicated tracheostomy service obtained a higher mean score (7.1/10) and demonstrated greater anxiety when managing patients with stomas (p < 0.001), as well as an increased willingness to undergo specific training (p = 0.017) to reduce their lack of self-confidence.

Conclusions

A higher level of anxiety in the management of tracheostomised patients and a greater interest in receiving specific training have been observed among nurses in hospitals with advanced practice services (APTS), despite having greater training. Therefore, institutions should commit to incorporating advanced practice nurses and continuing education in the approach to ostomies among their professionals.

Implications for the Profession and/or Patient Care

Implementing ongoing training programmes and specific tracheostomy services or units in hospitals would enable nurses to provide high-quality care for patients with respiratory stomas.

Reporting Method

The study adhered to the STROBE checklist.

Patient or Public Contribution

Neither patients nor the public were involved in the design or conduct of this research. Nurses participated exclusively in data collection.

Mejoras en las intervenciones asistenciales durante el periodo de transición a la vida extrauterina neonatal

Objetivo y Metodología: Este trabajo engloba una completa revisión de la literatura crítica sobre las investigaciones más relevantes y actuales en la evolución y postura de las diferentes estrategias en la reanimación neonatal. Resultados principales: Es necesario instaurar un soporte de transición al neonato en el periodo de adaptación, la demora en el pinzamiento del cordón umbilical será de al menos 1 minuto, la temperatura óptima en el neonato oscila entre 36,5-37,5ºC. El soporte ventilatorio en los prematuros, debería utilizarse inicialmente o bien aire o bien concentraciones bajas de oxígeno (hasta 30%). Si a pesar de una ventilación efectiva la oxigenación, siguiera siendo inaceptable, debería considerarse la utilización de concentraciones de oxígeno más elevadas. Conclusión principal: Los esfuerzos para mejorar la secuencia en la actuación ante una reanimación en los diferentes hospitales de forma consensuada y reducción de la incidencia de asfixia perinatal y morbi-mortalidad neonatal.