DOI: https://doi.org/10.53350/pjmhs2023176134 ORIGINAL ARTICLE 134 P J M H S Vol. 17, No. 6, Jun, 2023 Descriptive Study Evaluating Nurses Knowledge and Practices Regarding Tracheostomy Care in ICU patients ADEEBA KHANUM 1 , GULZAREEN 1 , MUBEEN OWAIS 2 , GHULAM FIZZA 3 , FARHAT MIRAN BUKSH 1 , SAMINA NAZIR 1* 1 Nursing Instructor, College of Nursing UCHS Children Hospital, Lahore –Pakistan 2 Department of Nursing, Manager, College of Nursing UCHS Children Hospital, Lahore –Pakistan 3 Nursing Instructor, College of Nursing, Khawaja Muhammad Safdar Medical College, Sialkot –Pakistan Correspondence to Miss. Samina Nazir, Email: saminakhalil@outlook.com.Tel:+92-335-4277441 ABSTRACT Background: ICU patient tracheostomy care is a fundamental nursing procedure. The tracheostomy might result in difficulties and causes a great deal of anxiety in patients. A low level of care can have negative consequences such as longer hospital stays, slower recovery times, and greater mortality rates. Aim: To evaluate nurses' tracheostomy care knowledge and practises in ICU patients. Study Design: The descriptive research study design was used. Methodology: 75 nurses who worked in the ICU of three public hospitals in Lahore—Mayo Hospital, Jinnah Hospital, and Shaikh Zayed Hospital—were included in the study's sample. Nurses' practises were assessed by direct observation using a checklist, and their knowledge was assessed using a self-structured questionnaire. The analysis of the data was done using SPSS v 20.0. Results: All participants in the study were ICU nurses. This data makes clear that 0 - 49% of nurses have low knowledge, while 50 - 64% of nurses have average knowledge, and >65% of nurses have adequate knowledge. Conclusion: The majority of participants had sufficient understanding of tracheostomy care. Additionally, it demonstrates that out of 75 nurses, only 0–59% had insufficient skill and > 60% had a sufficient level of performance. Practical Implementation: This study assisted researchers in examining the risk variables related to Tracheostomy treatment in ICU patients because of the increasing number of patients in the ICU. Conclusion: It was concluded that, despite having sufficient information, nurses performed poorly when providing tracheostomy care. Therefore, for the safety of patients, health care facilities must provide organized clinical guidelines and practices. Keywords: Assessment, Knowledge, Practice, Nursing Care and Tracheostomy. INTRODUCTION In hospitals, tracheostomy tubes are implanted. To secure upper airway obstruction, it may be done in the operating room or intensive care unit 1 . The earliest recognised surgical operation since antiquity is tracheostomy. On Egyptian tablets from 3600 B.C., it was scored. Both acute care hospitals and long-term care facilities routinely provide tracheostomy care. The patients benefit significantly from quality tracheostomy care 2 . Therefore, it is crucial that nurses are well-prepared with the necessary skills and knowledge for caring for tracheostomies in order to avoid any potential difficulties that may arise from poor nurse management. Typically, the nurses are the ones to analyse the issue initially and contact the attending doctor or surgeon right once if there is a problem. Most ICU patients require tracheostomies for long-term ventilation, about one-third of them. Tracheostomy care is crucial in both the intensive care setting and the general ward, as the prevalence of tracheostomies is rising globally 3 . It is increasingly crucial that qualified nurses have the necessary training, knowledge, and support to address each patient's specific needs in a safe and effective manner. Lack of education and training can result in a number of major problems. The larynx and the bronchi of the lungs are joined by the trachea, a large resonant tube. Beginning from the base of the larynx, it terminates at the carina. The trachea is encircled by cartilage rings, and an adult's trachea measures 1.5 to 2cm in inner diameter. The wind pipe, which is a fundamental component of the airway and essential to breathing, is around 10 to 12cm long 4 . In order to maintain airway integrity and remove upper airway obstruction, tracheostomies are performed by creating an opening between three and four cartilage rings on the front wall of the trachea. To maintain an airway, a tracheostomy tube is inserted. The tracheostomy tube enables the patient to alternate between breathing via their mouth and nose and their windpipe directly. Airway obstruction, bilateral vocal cord paralysis, laryngeal ----------------------------------------------------------------------------------------- Received on 26-12-2022 Accepted on 07-05-2023 cancer, chronic obstructive pulmonary disease, congenital airway obstruction, head injury, and burn patients with airway injury are among the conditions that call for tracheotomies. When oral or nasal intubation is not an option, it is often required in neurological illnesses such as trauma, coma, head and neck surgery, and acute airway obstruction. It could be temporary or permanent and might be carried out as a scheduled procedure or in an emergency 4,5 . To prevent potential complications, tracheostomy patients need intensive and specialised nursing care. Emergencies that could happen right away during a tracheostomy procedure include bleeding from the skin, tube displacement and airway loss, and tube obstruction. When all necessary equipment is readily available at the bedside, such emergencies can be handled more effectively by a qualified medical team 6 . Tracheal stenosis, tracheal esophageal fistula, and tracheomalacia are examples of late complications. In addition to adequate and timely suction, stoma cleaning, control of tracheostomy cuff pressure, avoidance of skin infection, and balanced diet are all aspects of nursing care for tracheostomy patients. Patients who have had a tracheostomy may require oral care due to the altered upper airway. A knowledgeable nurse should evaluate the oral care. Since nurses constantly take care of the patients, they are in charge of the care's quality 7 . One study revealed that normal saline instillation lower respiratory tract infection 8 . It is usually a misconception that it helps in liquefying secretions. The potential hazards of normal saline instillation include a fall in PaO2; a survey found that 33% of nurses still use saline before and during suctioning. It is vital that the nurses should be adequately trained and competent enough in the care of a patient with a tracheostomy 9 . One of the practices that create anxiety among many nurses is tracheostomy care. Persistent demand for critical care bed means that standardized information should be provided because newly formed tracheostomies require sufficient time in the formation of stoma. It is necessary that the tube should not be change for the first 7-10 days 10 . According to reports, nurses working in intensive care units and regular wards lack the knowledge, confidence, and skills necessary to provide tracheostomy care 6 . Due to lack of research and debate on this important health issues, we planned current