• Mary Lou Sole, Steven Talbert, Daleen Aragon Penoyer, Melody Bennett, Steven Sokol, and Jason Wilson.
• Mary Lou Sole is a professor, University of Central Florida, Orlando, and a nurse scientist, Orlando Health, Orlando, Florida. Steven Talbert is a clinical assistant professor at University of Central Florida. Daleen Aragon Penoyer is the director of nursing research, and Steven Sokol is a clinical informatics specialist, Orlando Health. Melody Bennett is an adjunct faculty member, University of Central Florida, and a clinical research coordinator at Orlando Health. Jason Wilson is a consultant with WeizerMazars, LLP, Smart Solutions Healthcare Group, New York and Central Florida. Mary.Sole@ucf.edu.
• Am. J. Crit. Care. 2014 Nov 1;23(6):e80-7.

BackgroundA tracheostomy is often performed when patients cannot be weaned from mechanical ventilation. Respiratory infections (ventilator-associated pneumonia and infection of the lower respiratory tract) complicate the course of hospitalization in patients receiving mechanical ventilation.ObjectivesTo evaluate respiratory infections before and after a percutaneous tracheostomy and to describe their outcomes.MethodsMedical records of adults who had percutaneous tracheostomy during a 1-year period at a tertiary care hospital in the southeastern United States were reviewed retrospectively.ResultsData for 322 patients were analyzed. Patients were predominately male (63.0%) and white (57.8%), with a mean age of 57.4 years. Ventilator-associated pneumonia or infection of the lower respiratory tract was identified in 90 patients (28.0%); the majority of infections were lower respiratory infections. Of all infections, 52% occurred before the tracheostomy, and 48% occurred after the procedure. Respiratory infections were associated with longer stays and higher costs, which were significantly higher in patients in whom the infection developed after the tracheostomy. Gram-negative organisms were responsible for the majority of infections.ConclusionsData related to respiratory infections that occurred before a tracheostomy were similar to data related to infections that occurred after a tracheostomy. Most infections were classified as lower respiratory infection rather than pneumonia. Infection, before or after a tracheostomy, resulted in longer stays and higher costs for care. Interventions focused on preventing infection before and after tracheostomy are warranted.©2014 American Association of Critical-Care Nurses.

39 keywords...

hide…