1. Jeffries, Marian MSN, RN, FNP-C

Article Content


To care for patients with a tracheostomy, nurses need to be knowledgeable about tracheal airway management and able to communicate this information to the patient using various methods for comprehension.



The purpose of this project was to develop practice guidelines for teaching tracheostomy care that included both the patient and family using a multifaceted approach with a focus on discharge planning.



The large volume of patients admitted with a tracheostomy to the general care units within the hospital illuminated a need for a consistent approach to teaching tracheostomy care prior to discharge. Teaching patients and family members about tracheal airway needs while anticipating discharge to home or rehabilitation units should be uncomplicated, with visual cues and patient interaction. A Teaching Guide was proposed for the general care units (Adult and Pedi) along with obtaining a Tracheal Mannequin and mirror for each unit.



The teaching guide was developed and implemented. It contains instructions for teaching (for the nurse), visual tear-off sheets for suctioning and cleaning, information booklets about tracheostomy, as well as community and medical alert information. A grant was obtained to purchase tracheal mannequins and mirrors. All equipment were distributed to CNSs on the designated units for nurse review prior to use.



The CNS focused on improving current nursing standards of care for the patient with a tracheostomy by using visual models and cues to supplement the usual reading material in teaching self-care. Feedback from the units indicates an improved awareness of the needs of these patients as well as patients demonstrating fine technique in suctioning and self-care.


Implications for Nursing Practice

The effectiveness of these CNS interventions will be monitored through an existing annual nurse survey, which includes common patient problems.


Section Description

This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.