Nurs Crit Care. 2026 Mar;31(2):e70282. doi: 10.1111/nicc.70282.
ABSTRACT
BACKGROUND: Tracheostomy is a common procedure in intensive care units (ICUs), with a rising number of patients requiring specialised nursing care. Effective tracheostomy management is critical for preventing complications such as tube blockage, infection and bleeding. Critical care nurses play a pivotal role in ensuring patient safety, highlighting the need for innovative approaches to enhance their knowledge and clinical performance.
AIM: To evaluate the effect of implementing a Tracheal nursing care bundle on critical care nurses’ knowledge and performance in the ICU.
STUDY DESIGN: A quasi-experimental design was conducted involving critically ill adult patients with tracheostomies and ICU nurses. Data were collected using three tools: (i) a self-administered questionnaire to assess nurses’ knowledge, (ii) a pre-post observational checklist to evaluate nurses’ performance in applying the Tracheal nursing care bundle and (iii) a patient outcome sheet documenting demographic characteristics, adverse events and tracheostomy-related complications.
RESULTS: A total of 60 critical care nurses and 60 ICU patients participated in the study. Post-implementation of the Tracheal nursing care bundle, there was a statistically significant improvement in nurses’ knowledge and practice, with 81.7% achieving adequate performance levels. The overall complication rate significantly decreased (pre 28.3% (n=17) vs. post 8.3% (n=5), p=0.006).
CONCLUSIONS: The Tracheal nursing care bundle enhanced ICU nurses’ knowledge and performance, leading to a reduction in tracheostomy-related complications and improved patient outcomes.
RELEVANCE TO CLINICAL PRACTICE: Implementation of structured care bundles, such as the Tracheal nursing care bundle, strengthens evidence-based tracheostomy management in ICUs. By standardising nursing practice, the bundle reduces preventable adverse events, reinforces patient safety and supports high-quality care delivery. Incorporating such interventions into routine ICU practice can optimise patient outcomes and empower nurses with the confidence and competence required for managing tracheostomies effectively.
PMID:41614279 | DOI:10.1111/nicc.70282
