Sygepleje til trakeostomerede patienter

Between 50 and 83 per cent of patients with a tracheostomy have difficulty swallowing. A study comprising 553 patients found aspiration and silent aspiration in respectively 48.8 per cent and 36.8 per cent of patients. As aspiration into the lungs is the commonest cause of hospital-acquired infection, it is vital to identify patients at risk of dysphagia. The purpose of this article is to describe experiences in developing a set of evidence-based clinical guidelines on nursing care of tracheostomised patients at risk of dysphagia. The focus of nursing care was whether patients should take fluid/food when the tracheostomy is cuffed; whether nurses should ideally test patients for mis-swallowing and the extent to which nurses can prevent mis-swallowing. A systematic review showed that it makes a difference whether the patient is cuffed or uncuffed when fluid/food is administered. We also found a number of tools suitable for use in testing for dysphagia. We still do not know whether dysphagia can be prevented in tracheostomy patients, as we did not find answers to this question in the scientific literature..