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International Journal of Otolaryngology
Volume 2010, Article ID 638742, 7 pages
http://dx.doi.org/10.1155/2010/638742
Research Article

Identifying and Improving Knowledge Deficits of Emergency Airway Management of Tracheotomy and Laryngectomy Patients: A Pilot Patient Safety Initiative

1Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA 94115, USA
2Department of Anesthesia, University of California, San Francisco, CA 94115, USA
3Department of Nursing, University of California, San Francisco, CA 94115, USA
4Quality Improvement Department, University of California, San Francisco, CA 94115, USA

Received 10 February 2010; Accepted 23 March 2010

Academic Editor: Charles Monroe Myer

Copyright © 2010 Ivan H. El-Sayed et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To evaluate the knowledge base of hospital staff regarding emergent airway management of tracheotomy and laryngectomy patients, and the impact of the introduction of a bedside airway form. Methods. Cross-sectional surveys of physicians, nurses, and respiratory therapists at a tertiary care hospital prior to and 24 months after introduction of a bedside Emergency Airway Access (EAA) form. Results. Pre- and postintervention surveys revealed several knowledge deficits. Preintervention, 37% of medical internists and 19% overall did not know that laryngectomy patients cannot be orally ventilated, and 67% of internists could not identify the purpose of stay sutures in recently created tracheotomies. Postintervention, these numbers improved for all groups. Furthermore, 80% of respiratory therapists reported encountering the EAA form in an emergent situation and found it useful. Conclusion. A knowledge deficit is identified in caregivers expected to provide emergency management of patients with airway anatomy altered by subspecialty surgeons. Safety initiatives such as the EAA form may improve knowledge among providers.