Tracheostomy care: Clinical practice patterns of pediatric otolaryngologists-head and neck surgeons in a publicly funded (Canadian) health care system.
OBJECTIVES
To investigate variability in pediatric tracheostomy tube care practice patterns and access to resources across Canada.


METHODS
Canadian pediatric otolaryngologists-head & neck surgeons reported their own practice patterns for children with chronic tracheostomy tubes using a web-based, 29-item multiple choice and short answer questionnaire. Domains investigated included tracheostomy team membership, inpatient care practices, caregiver education, homecare resources, speech and communication, and completeness of emergency tracheostomy kits.


RESULTS
The response rate was 86.4% (38/44). Most respondents care for children with tracheostomy tubes as part of an inter-professional team (25/36; 69.4%) and arrange routine follow-up with a speech and language pathologist (22/36; 61.1%). However, the majority (23/34; 67.6%) of respondents do not formally reassess caregiver competencies (i.e. cardiopulmonary resuscitation, emergency tracheostomy care). Notably, respondents were also unsure 36.1% (13/36) of how frequently Shiley tracheostomy tubes should be washed and reused with the majority (15/36; 41.7%) reporting never. Most (15/36; 41.7%) respondents were also unsure of reuse recommendations for Bivona tracheostomy tubes. One third (12/36; 33.3%) of respondents were unsure about government-funded homecare services being provided in their community to children with tracheostomy tubes.


CONCLUSION
There is much variability in pediatric tracheostomy tube care practice patterns across Canada. Results suggest that an evidence-based Canadian clinical practice guideline may help to streamline care provided to Canadian children with tracheostomy tubes.
['Rai|Sunita K|SK|', 'Holler|Theresa|T|', 'Propst|Evan J|EJ|', 'Wolter|Nikolaus E|NE|', 'Amin|Reshma|R|']
D002170:Canada D017028:Caregivers D002648:Child D003430:Cross-Sectional Studies D003695:Delivery of Health Care D004638:Emergency Treatment D005260:Female D006297:Health Services Accessibility D006760:Hospitalization D006801:Humans D008297:Male D000072220:Otolaryngologists D010818:Practice Patterns, Physicians' D066231:Surgeons D011795:Surveys and Questionnaires D014139:Tracheostomy
Pediatric Artificial respiration Chronic ventilation Quality Tracheotomy