An Investigation of the Barriers to Care of Adult Patients With a Tracheostomy in Intensive Care Units and General Wards: Secondary Analysis of Qualitative Interview Data

Abstract

<p><i>Aims and Objectives</i> To investigate the barriers experienced by intensive care nurses and registered nurses and to provide optimal nursing for adult patients with a temporary tracheostomy in intensive care and general wards. <p><i>Background</i> Tracheostomy is widely used in intensive care units, around 20% of intensive care unit patients undergo tracheostomy insertions and expect high quality of care. Caring for patients with a tracheostomy is complex and challenging task. An investigation of barriers to care for adult patients with a temporary tracheostomy in a hospital setting is essential to ensure that these patients receive the highest quality of care and to identify areas for improvement. <p><i>Design</i> This paper applied secondary analysis to data from two qualitative studies, including narrative interviews and maximum variation sampling. <p><i>Methods</i> Secondary analysis of primary qualitative datasets is appropriate when the analysis extends rather than exceeds the primary. The analysis was based on interview data collected from six intensive care nurses and six registered nurses from two university teaching hospitals in Norway. The interviews were audio-recorded and transcribed. The data was analysed using the qualitative analysis suggested by Graneheim and Lundman. This study adhered to the consolidated criteria for reporting in a qualitative research (COREQ) checklist. <p><i>Results</i> Four main themes were identified as barriers to care for adult patients with a temporary tracheostomy in the hospital: encountering ambivalence, inadequate staffing levels, lack of patient continuity of care and lack of systematic follow-up. <p><i>Conclusions</i> Understanding barriers to care is crucial for hospitals and healthcare organisations to develop targeted interventions and educational programs to address these barriers and improve the care provided to adult patients with tracheostomies in hospital settings.