THE DEVELOPMENT OF CLINICAL PRACTICE GUIDELINE FOR PATIENTS ON TRACHEOTOMY TUBE

Tracheotomy Tube is vital in keeping the patient’s lower airway open to improve ventilation and oxygenation. In order to prevent complications, an effective management of tracheotomy tube should be proficient. This study was aimed to develop clinical practice guidelines for tracheotomy tube care and explore the possibility of implementing the practice in the Intensive Care Units and the Coronary Care Unit (CCU) of Bumrungrad International. The subjects consisted of two groups selected through purposive sampling. The first group included panel of experts from doctors and nurses. The second group included health care workers from the intensive care unit and the Coronary Care Unit in Bumrungrad International. The study went through 4 stages. The first stage was the analysis of the issues about tracheotomy tube care. On the 2nd stage, the clinical practice guidelines were developed and applied based on the framework from the National Health and Medical Research Council, Australia on the practice of tracheotomy tube care. The clinical practice guideline was assessed for content validity by 5 experts. Reliability was tested using Kuder-Richardson 20 (KR-20). On the third stage, the clinical practice guideline was tested for feasibility and applicability among 106 health care workers. On the 4th stage, the clinical practice guideline was refined during a forum. Data was analyzed by using percentage and categorization. The result of the study revealed that the clinical practice guideline for tracheotomy tube care in Critical Care Unit at Bumrungrad International had 54 items. The clinical practice guideline consisted of cuff tube management which divided inflate cuff tracheotomy tube into eight items, deflate cuff pressure of tracheotomy tube in the patient who had ventilator into eight items, changing tracheotomy site and inner tube into nineteen items. The clinical practice guideline’s feasibility and applicability rate is 97.47 percent. It is therefore concluded that the clinical practice guideline can improve the quality of nursing practice in caring of tracheotomy tube patients.