Clinical Nurse Specialist Tracheostomy Management Improves Patient Outcomes

Background: Patients with a tracheostomy are a low-volume, high-risk population with long lengths of hospital stay and high health care costs. Problem: Because of the complex nature of caring for patients with a tracheostomy, it is essential to provide a standardized care approach with ongoing monitoring to optimize outcomes. Approach: A pre/postimplementation design was used. A formal tracheostomy care management process using clinical nurse specialists (CNSs) was implemented. Outcomes: Between April 2019 and December 2020, this process resulted in a significant reduction in time between tracheostomy placement and discharge, from 16 to 12.9 days ( P = .02). Reductions were also seen in length of stay and incidence of tracheostomy-related pressure injuries. Conclusions: This project shows that a CNS-led care management process can improve patient outcomes. These improvements in patient outcomes resulted in a significant cost savings to the organization.