Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress ePosters 53 eP09 Scrub nurse intervention in surgical tracheostomy for intensive care patients during COVID-19 emergency period A. Oliva López1, M.T. Inza Urrea1, C. Inza Urrea1, M.V. Martinez2, E. Gonzalez Fernandez1, R. Torralba Herrero1, I. Pastor Martinez1, P. Ferrandiz Garcia1, M. Del Olvido Diaz Ruiz1 1SESCAM, Hospital Hellin Quirofano, Hellin, Spain, 2Hospital Hellin Quirofano, Hellin, Spain Objective: Significantly reduce the exposure time of the surgical staff to SARS-CoV-2 during surgical tracheotomy procedure performed to critical patients affected by COVID-19 in ICU department. Method: Timing control, from the arrival into ICU department until this place was left. Sterile field prepared and properly isolated in OR which was adequately transported into ICU department afterwards. Results: At the beginning, the OR team -anaesthetist, ENT surgeon and two scrub nurses- wore their PPE from the OR department. The time required to get the PPE in place, prepare the sterile field at patient’s bedside and perform the tracheotomy intervention in ICU was 1 hour 30 minutes per patient. Afterwards, for the following interventions, OR department was equipped with a ‘tracheotomy trolley’, containing all the required materials, including surgical tray with the instruments. This way the OR staff were able to prepare a sterile field at this department and to cover it with different layers of drapes to protect the sterile items on its way to ICU. This method obtained a more effective management of time, therefore the OR team achieved to get to ICU in less than 15 minutes since the sterile instruments were opened. Time required for the whole assistance, since the team left the OR department until they came back were 45 minutes per patient. Conclusions: Health workers can benefit significantly from a reduced exposure to SARS-CoV-2 when performing an emergency tracheotomy to ICU patients suffering from COVID-19 if the tracheotomy material required is prepared and transported from the OR scrub nurses guaranteeing the sterile conditions of the surgical items. There were not reported surgical site infections related to this procedure in those patients. There were no infections reported by the staff involved in the procedure 15 days after they were performed. eP10 Preventing pressure injuries in the tracheostomy patient H. Swan1 1Stanford Hospital, CVOR, Stanford, United States Introduction: A common area for pressure injuries to occur in the tracheostomy patient population is at the flange base of the tracheostomy tube. Injuries in this area are subjected to tight sutures, secretions, and dressing changes. Prevention of medical device related injuries is one of Stanford Hospital priorities. Method: A collaboration of nurses, physicians, wound care management, and operating room management worked together to evaluate our current process for placing new tracheostomy tubes. Factors including tightness of sutures, length of time from suture insertion to removal, dressing type, and tracheostomy tube flexibility were evaluated. A trail of a flexible, translucent flanged tracheostomy tubes proceeded including multiple service disciplines. Results: Working together we were able to decrease the number of sutures used during the tracheostomy tube placement, standardizing the dressing type used directly after surgery and postoperatively, easier skin assessments were performed, and no early decannulations occurred. The positive trial of flexible tracheostomy tubes led to a full facility conversion. Conclusion: The softer clear material of the new tracheostomy tube has many advantages. Surgical skin assessments can be performed through the clear flange base. Softer flanged base has multiple openings allowing air contact to the underlying skin. Reduction in the number of sutures placed during surgery provides less surgical trauma, reduced skin to device contact, and easier changing of dressing. Early decannulations were avoided.
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