HSC Section 3 - Trauma, Critical Care and Sleep Medicine

O’Toole et al

Figure 4. TRAPU bundle outcome timeline. TRAPU, tracheostomy-related acquired pressure ulcer.

Table 4. Protocol Compliance: Random Audit Findings. a

DuoDERM Present Suture Removal before Day 8 b

Patient

PolyMem Present Head and Neck Position Overall Compliance

1 2 3 4 5 6 7 8 9

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes

Yes (7)

Yes

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes

Yes Yes Yes Yes No Yes Yes Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Yes

D/C

D/C

Yes (7)

Yes

D/C

D/C

No (11)

Yes

D/C D/C

D/C D/C D/C Yes Yes Yes Yes Yes Yes D/C D/C

Yes (7) Yes (7) No (8) Yes (7) Yes (5) Yes (7) Yes (3) D/C

10 11 12 13 14 15 16 17 18 19

D/C

Yes (6)

Yes

D/C

D/C

Yes (5)

Yes

Total, % (n)

95 (18 of 19)

89 (17 of 19)

100 (19 of 19)

95 (18 of 19)

84 (16 of 19)

Abbreviation: D/C, discharged. a Results of the random audits for the 19 patients selected. For the sake of determining compliance, patients who were discharged before day 7 were auto- matically considered to be compliant for suture removal, and if sutures were not removed before discharge, patients were also considered compliant with regard to PolyMem placement. b The number in parentheses is the postoperative day of suture removal.

surrounding the tracheostomy stoma. 15,16 Reports from these studies suggested that dressings may remain adherent for an average of 4 days after placement, which could reduce the burden of frequent dressing changes usually placed on the nursing staff. 16 These occlusive dressings

were felt to protect the skin by limiting contact with moist- ure from tracheal secretions. 15 In this study, we utilized DuoDERM, an adhesive hydro- colloid dressing, as an occlusive barrier. Anecdotally, this dressing could become nonadherent when exposed to

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