Tracheostomy patients on the ward multiple benefits from a multidisciplinary team 英文参考文献.docVIP

Yu Critical Care 2010,14:109 /content/14/1/109 COMMENTARY Tracheostomy patients on the ward: multiple bene? ts from a multidisciplinary team? Mihae Yu* See related research by Garrubba et al., /content/13/6/R177 found only three studies [2-4] assessing the impact of a Abstract multidisciplinary team (MDT) on outcome of tracheo- Patients requiring tracheostomies tend to have a longer length of stay due to their underlying disease. After a thorough literature search, Garrubba and colleagues found only three studies assessing the impact of multidisciplinary teams (MDTs) on tracheostomy patients on the ward. One consistent observation was the decreased time to decannulation after institution of MDT care when compared with historical controls. Although a large prospective randomized trial is desirable before MDT is recommended, many institutions may have already formed a team approach to provide coordinated care stomy patients on the ward. All studies compared results with historical controls, and despite the problems intrinsic in cohort studies, the consistent observation was decreased time to decannulation [2-4], and two of the three studies revealed decreased length of stay [3,4]. Speci? c outcomes and complications pertinent to tracheo stomy patients were notably absent in these studies, although the implication is improved patient care. One study [2] reported improvement in nursing compliance of tracheostomy care plan after institution of MDT, and death and code blues were less common (albeit not statistically signi? cant) in the other two studies [3,4]. resulting in improved outcome and length of stay. In regard to tracheostomy patients, there are multiple variables that may impact clinical outcome, complica- tions, or length of stay or all three. Some of these Tracheostomy is one of the most frequent procedures done in an intensive care unit (