Ventilator-tube holder for mobilising patients with a tracheostomy: A pilot usability study (TrachVest).

ABSTRACT

INTRODUCTION: Patients in intensive care may have a tracheostomy and be dependent on a respiratory ventilator while yet conscious and able to mobilise. Early rehabilitation is known to be key to patient recovery. However, for these patients, therapy staff members are required to manage the ventilator tubing in addition to other patient-connected equipment whilst focussing on patient mobility and progress. A technical garment (TrachVest) was designed to hold the ventilator tubing securely during these therapeutic mobilisations. METHODS: We conducted a mixed-methods study to evaluate the use of this garment in an intensive care unit setting. The aim was to determine potential effects on patient safety, its potential benefits, and usability. Research methods included direct observations, user questionnaires (quantitative and qualitative), and staff focus groups. RESULTS: A total of 14 therapy sessions with the garment were observed, involving nine patients and 10 staff. Eleven staff members participated in two focus groups, including two previously involved in the therapy sessions. Therapy sessions consisted of a range of activities including sitting on the edge of the bed, transferring from bed to chair (including use of hoists), and mobilising with walking aids. Overall, staff members felt that the garment was easy to use and would likely improve patient safety during mobilisations. The main benefits were staff reassurance, allowing them to focus on therapy, and in potentially reducing the number of staff members needed for particular activities. Patient characteristics were found to be influential on the perceived utility, and TrachVest may have greater benefit for patients who have greater physical function (e.g., able to actively participate in rehabilitation) and can mobilise at least from bed to chair. Experience of using the TrachVest and of patient capabilities was thought to be key to knowing when it would be most useful. CONCLUSION: Within this pilot usability study, participants, both staff and patients, reported that the TrachVest garment designed to support ventilator tubing during rehabilitation to be highly useable and beneficial to supporting rehabilitation in this patient group.