Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-26T22:26:13.440Z Has data issue: false hasContentIssue false
  • English
  • Français

Retrospective, cross-sectional review of delayed discharge after paediatric tracheostomy

Published online by Cambridge University Press:  16 October 2012

A Rafferty ,
D Knight ,
S Bew  and
L Knight
A Rafferty*
Affiliation:
Department of ENT, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, UK
D Knight
Affiliation:
Newcastle University Medical School, UK
S Bew
Affiliation:
Department of Anaesthetics, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, UK
L Knight
Affiliation:
Department of ENT, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, UK
*
Address for correspondence: Miss Amy Rafferty, 1 Bowood Crescent, Meanwood, Leeds LS7 2PY, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To investigate reasons for prolonged hospitalisation of children with tracheostomies once they are medically fit for discharge.

Methods:

Retrospective, cross-sectional study of 101 children undergoing tracheostomy between 2000 and 2010.

Results:

Of the study patients, 44.6 per cent did not spend any time in hospital once medically fit, 19.8 per cent spent up to two weeks, 12.9 per cent spent between two weeks and one month, and 22.8 per cent spent over one month. Of the 56 cases with delayed discharge, the majority (22 children, 39.3 per cent) were delayed due to time taken obtaining parental competencies in tracheostomy management. A number of external factors were identified in these delays: parental substance abuse; single parenting; concerns about parenting ability, and English not being the parents' first language.

Conclusion:

Paediatric tracheostomy may lead to prolonged hospitalisation, but this is often influenced by social factors. Better use of dedicated specialist paediatric tracheostomy nurses may reduce unnecessary hospitalisation.

Keywords

TracheostomyInfantChildLength Of StaySocial Problems
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 12 , December 2012 , pp. 1247 - 1253
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented orally at the European Society of Pediatric Otorhinolaryngology, 5–8 June 2010, Pamplona, Spain, and at the Yorkshire Paediatric Society Winter Meeting, 8 February 2011, Leeds, UK.

References

1Arcand, P, Granger, J. Pediatric tracheostomies: changing trends. J Otolaryngol Suppl 1988;17:121–4Google ScholarPubMed
2Wetmore, R, Marsh, R, Thompson, M, Tom, L. Pediatric tracheostomy: a changing procedure? Ann Otol Rhinol Laryngol 1999;108:695–9CrossRefGoogle ScholarPubMed
3Wetmore, R, Handler, S, Potsic, W. Pediatric tracheostomy. Experience during the past decade. Ann Otol Rhinol Laryngol 1982;91:628–32CrossRefGoogle ScholarPubMed
4Hadfield, PJ, Lloyd-Faulconbridge, RV, Almeyda, J, Albert, DM, Bailey, CM. The changing indications for paediatric tracheostomy. Int J Pediatr Otorhinolaryngol 2003;67:7–10CrossRefGoogle ScholarPubMed
5Zenk, J, Fyrmpas, G, Zimmermann, T, Koch, M, Constantindis, J, Iro, H. Tracheostomy in young patients: indications and long-term outcome. Eur Arch Otorhinolaryngol 2009;266:705–11CrossRefGoogle ScholarPubMed
6Duncan, BW, Howell, LJ, deLorimier, AA, Adzick, AS, Harrison, MR. Tracheostomy in children with emphasis on home care. J Pediatr Surg 1992;27:432–5CrossRefGoogle ScholarPubMed
7Edwards, EA, O'Toole, M, Wallis, C. Sending children home on tracheostomy dependent ventilation: pitfalls and outcomes. Arch Dis Child 2003;89:251–5CrossRefGoogle Scholar
8American Thoracic Society. Care of the child with a chronic tracheostomy. Am J Respir Med 2000;161:297–308CrossRefGoogle Scholar
9Hopkins, C, Whetstone, S, Foster, T, Blaney, S, Morrison, G. The impact of paediatric tracheostomy on both patient and parent. Int J Pediatr Otorhinolaryngol 2009;73:15–20CrossRefGoogle ScholarPubMed
10Spentzas, T, Auth, M, Hess, P, Minarik, M, Storgion, S, Stidham, G. Natural course following pediatric tracheostomy. J Intensive Care Med 2010;25:39–45CrossRefGoogle ScholarPubMed
11Saurel-Cubizolles, MJ, Zeitlin, J, Lelong, N, Papiernik, E, Di Renzo, GC, Breart, G. Employment, working conditions, and preterm birth: results from the Europop case-control survey. J Epidemiol Community Health 2004;58:395–401CrossRefGoogle ScholarPubMed
12Graf, JM, Montagnino, BA, Hueckel, R, McPherson, ML. Children with new tracheostomies: planning for family education and common impediments to discharge. Pediatr Pulmonol 2008;43:788–94CrossRefGoogle ScholarPubMed
13Tearl, DK, Hertzog, JH. Home discharge of technology-dependent children: evaluation of a respiratory-therapist driven family education program. Respir Care 2007;52:171–6Google ScholarPubMed
14Royal College of Nursing: Pay rates 2008/2009. In: http://www.rcn.org.uk/support/pay_and_conditions/nursing_pay_rates_200809 [17/11/11]Google Scholar