Unidad de Atención al Paciente Traqueostomizado. Una solución innovadora desde Otorrinolaringología con carácter transversal para el hospital / Tracheostomy Patient Care Unit. An innovative Otorhinolaryngology solution of a transversal nature for the hospital

Antecedentes y objetivo: Los cuidados de los pacientes traqueostomizados son habilidades de alto riesgo y baja incidencia. Las estrategias de mejora de la atención sanitaria en plantas hospitalarias y en especialidades distintas a la Otorrinolaringología (ORL) basadas únicamente en la formación no han sido capaces de ofrecer una solución adecuada. Se presenta un modelo de Unidad de Atención al Paciente Traqueostomizado dirigida por el Servicio de Otorrinolaringología para atender a todos los pacientes traqueostomizados de un hospital en todas las especialidades. Material y métodos Ámbito: hospital universitario público de tercer nivel con 876 camas de hospitalización y 30 camas de UCI para 481.296 habitantes. Modelo de Unidad: unidad transversal para el hospital proporcionando atención a todos los pacientes traqueostomizados, adultos y niños, de todas las especialidades, con dedicación del 50% de una enfermera de ORL de hospitalización que se desplaza hasta la cama de hospitalización de la especialidad de cada paciente y el 50% de otra enfermera de ORL de consultas externas para los pacientes ambulatorios, con la consultoría de un especialista en ORL y coordinación de la supervisora de ORL. Resultados Se atendió en la unidad a 572 pacientes entre 2016 y 2021, el 80% varones, con una media de edad de 63±14 años. Se atendieron 14,7±2 pacientes traqueostomizados diarios y 96±4 consultas por complicaciones anuales, elevándose hasta 19 pacientes traqueostomizados diarios en 2020 y 141±8,4 consultas por complicaciones en los años 2020 y 2021, durante la pandemia por COVID-19. Se redujo la estancia media de las especialidades no ORL en 13 días a lo largo de los 6 años del estudio, aumentando la satisfacción de los profesionales de ORL y de no ORL, y la satisfacción de los usuarios.... (AU)

Background and objective: The care of tracheostomized patients are high risk skills and low incidence. Strategies for improvement of health care in hospital wards and specialties other than otolaryngology based solely on training have not been able to offer an adequate solution. A tracheostomized patient unit is presented directed by the otolaryngology service to attend all tracheostomized hospitalized patients of all specialties. Material and methods Background: Third level public hospital with 876 hospitalization beds and 30 ICU beds for 481,296 inhabitants. Unit model: Transversal unit for the hospital providing attention to all tracheostomized patients, adults, and children, of all specialties, with dedication of 50% of a ENT nurse of hospitalization that moves to the hospitalization bed of the specialty of each patient and 50% of another office ENT nurse for ambulatory patients care, with the consultancy of an ENT specialist and coordinated by the ENT supervisor. Results 572 patients between 2016 and 2021, 80% men, aged 63±14 years, were attended in the unit. 14.7±2 tracheostomized patients daily and 96±4 complication annual consultations were attended, rising up to 19 tracheostomized patients daily by 2020 and 141±8.4 consultations by complications in 2020 and 2021, during the COVID-19 pandemic. The mean stay of the non-ENT specialties was reduced in 13 days, increasing the satisfaction of the ENT and non-ENT professionals and the satisfaction of the users. ... (AU)

Tracheostomy Patient Care Unit. An innovative Otorhinolaryngology solution of a transversal nature for the hospital.

BACKGROUND AND OBJECTIVE: The care of tracheostomized patients are high risk skills and low incidence. Strategies for improvement of health care in hospital wards and specialties other than otolaryngology based solely on training have not been able to offer an adequate solution. A tracheostomized patient unit is presented directed by the otolaryngology service to attend all tracheostomized hospitalised patients of all specialties. MATERIAL AND METHODS: Background: Third level public hospital with 876 hospitalisation beds and 30 ICU beds for 481,296 inhabitants. Unit model: Transversal unit for the hospital providing attention to all tracheostomized patients, adults, and children, of all specialties, with dedication of 50% of a ENT nurse of hospitalisation that moves to the hospitalisation bed of the specialty of each patient and 50% of another office ENT nurse for ambulatory patients care, with the consultancy of an ENT specialist and coordinated by the ENT supervisor. RESULTS: 572 patients between 2016 and 2021, 80% men, aged 63 ± 14 years, were attended in the Unit. 14.7 ± 2 tracheostomized patients daily and 96 ± 4 complication annual consultations were attended, rising up to 19 tracheostomized patients daily by 2020 and 141 ± 8.4 consultations by complications in 2020 and 2021, during the COVID-19 pandemic. The mean stay of the non-ENT specialties was reduced in 13 days, increasing the satisfaction of the ENT and non-ENT professionals and the satisfaction of the users. CONCLUSIONS: A Tracheostomized Patient Care Unit proactively directed from the Otorhinolaryngology Service to transversally care for all tracheostomized patients improves the quality of health care by reducing stay, complications, and emergencies. Improves the satisfaction of non-otolaryngological professionals by reducing the anxiety of facing care of patients who lack knowledge and experience and that of ENT specialists and nurses by reducing unplanned extemporaneous demands for care. Improves user satisfaction by perceiving adequate continuity of care. The Otorhinolaryngology Services provide their experience in the management of laryngectomized and tracheostomized patients and in teamwork with other specialists and professionals without the need to create new structures outside Otorhinolaryngology.

Adaptación transcultural al español de un cuestionario específico de calidad de vida en pacientes con traqueostomía / Transcultural adaptation to spanish of a specific questionnaire of quality of life in patients with tracheostomy

ntroducción: La traqueostomía es uno de los procedimientos quirúrgicos realizados con mayor frecuencia en el mundo. En Europa, a entre el 1.3 % y el 10 % de los pacientes hospitalizados en Unidades de Críticos se les realiza una traqueostomía. La traqueostomía provoca cambios físicos, funcionales, psicológicos, sociales, económicos y laborales en la vida del individuo que afectan a su calidad de vida. Siendo el cuestionario Tracheostomy Specific Quality Of Life (TQOL) una herramienta válida y fiable para su medición.Objetivo: Adaptar a la cultura y al idioma español un cuestionario específico para evaluar la calidad de vida de los pacientes con traqueostomía y medir su validez de contenido.Método: Se realizó una adaptación transcultural del inglés al español mediante el proceso de traducción-retrotraducción del cuestionario, seguido por una comprobación de la validez de contenido mediante un panel de expertos.Resultados: Los ítems del TQOL no presentaron problemas de traducción, se introdujeron cambios semánticos siendo la retrotraducción equivalente al original. Todos los ítems obtuvieron un índice de validez de contenido superior a 0,80, siendo el índice global de validez de contenido de la escala (S-CVI) de 0,98. El estudio piloto mostró adecuada comprensibilidad del instrumento.Conclusiones: Se ha obtenido una versión adaptada al español del TQOL lingüísticamente equivalente al cuestionario original para evaluar la calidad de vida en pacientes con traqueostomía. (AU)

Introduction: Tracheostomy is one of the most frequently performed surgical procedures in the world. In Europe, between 1.3% and 10% of patients hospitalized in Critical Units undergo a tracheostomy. The tracheostomy causes physical, functional, psychological, social, economic and work changes in the life of the individual that affect her quality of life. The Tracheostomy Specific Quality Of Life (TQOL) questionnaire is a valid and reliable tool for its measurement. Objective: To adapt to the Spanish culture and language a specific questionnaire to evaluate the quality of life of patients with tracheostomy and to measure its content validity. Method: A cross-cultural adaptation from English to Spanish was carried out by means of the translation-back-translation process of the questionnaire followed by a content validity check by a panel of experts.Results: The TQOL items did not present translation problems, semantic changes were introduced, the back translation being equivalent to the original. All items obtained a content validity index greater than 0.80, with the scale’s global content validity index (S-CVI) of 0.98. The pilot study showed adequate comprehensibility of the instrument.Conclusions: A version adapted to Spanish of the TQOL has been obtained, linguistically equivalent to the original questionnaire to evaluate the quality of life in patients with tracheostomy. (AU)