Assessments of the Practice and Knowledge of Health Professionals toward Tracheostomy for Patients Admitted to ICU in Ethiopian Hospitals

Abstract

Background: Tracheostomy is a surgical procedure commonly done in intensive care unit patients to facilitate weaning and to fasten the recovery process. More than 10% of mechanically ventilated patients require tracheostomy. The practice and knowledge of health professionals toward tracheostomy are left undisclosed and not well stated in Ethiopia. Materials and methods: This descriptive multicenter cross-sectional study was conducted with chart review and prospective evaluation of ICU health professionals’ knowledge regarding the practice of tracheostomy. This study was collected after distributing 24-item standard questionnaires to all health professionals who were working in surgical and medical intensive care units of Amhara regional comprehensive specialized hospitals (CSHs). All the data were entered and analyzed with SPSS version 25. Descriptive statistics, figures, and tables were used to present the data. Result: A total of 625 tracheostomies were done in our 3-year retrospective studies of 10 intensive care units of Amhara regional CSHs. We found that surgical tracheostomy was the commonest technique practiced currently in our setup. The majority of tracheostomy procedures were performed in the operation theater. Conclusion: Percutaneous tracheostomy was under-practiced in Amhara regional CSHs. The decision time to proceed with a tracheostomy was late, which was after 14 days of postintubation, in most cases. The knowledge of health professionals, who were working in intensive care units, regarding tracheostomy, was poor. Clinical significance: This study is one of the important areas in addressing peculiar gaps in the tracheostomy practice for mechanically ventilated patients in ICU, especially in low-income countries where tracheostomy-related complication is high. Knowing the practice and health professional’s knowledge toward tracheostomy is among the most important area of ICU care in medicine, and there is no previous published work within this regard in Ethiopia and in Africa.