trach patient

[Ms.RN]

Hi

I'm just curious to find out when you admit patient with trach, does your facility make sure all the trach supplies are ready like, trach mask, tubings, inner cannulas, obturator before patient is admitted or does your facility expect hospitals or whatever facility patient is transferred from to send enough supplies and wait unitil patient is admitted and order them and where?

[Reno1978, BSN, RN]

I work in a hospital and never really thought about if an LTC facility would have trach supplies or not. We always keep all of that in stock. I have nothing to add, except to say that your thread raises awareness for us hospital based nurses to ask if the facility our patients are going to has supplies or not. I'd be happy to send along several days worth of trach supplies if I knew the accepting facility would be short for a few days.

[suetje]

Oh, yes! suctioning set up, ambu bag, extra trach, obturator visible at head of bed, and difficult airway sign at HOB too. you can't expect the facility to send that stuff. You need to be ready with it.

[caring28]

I worked in home care with several trached patients, when they would go to our community hospital we would have to bring our own supplies from home because the hospital didn't have the supplies he needed. This hospital also didn't have a hoyer to be able to lift him in and out of the bed as he needed to be. It was very frustrating for us as primary care givers and for him as the patient!

[tewdles, RN]

This is part of what case managers are supposed to do...to facilitate a smooth transition from acute care hospitalization to the next place...doesn't always work that way though and not all hospitals "get" what a nurse case manager role involves. They forget the "patient advocate" part of nursing frequently, IMHO.

[CoffeeRTC, BSN, RN]

We all know what the right answer is to this question.

BTDT.

[SunnyAndrsn]

We have had a few trach pts. in the last two years, and have made sure all supplies are there beforehand. What would you do otherwise?

Dedicated ambu bag in the room, heat/humidity set up, spare trach for ER change, along with on size down, suction, suction catheters, sterile water, O2, circuits w/ circuit changes....everything. The nurses in the meantime try and go over procedures r/t trach cares, especially since we often have a lot of time in between pts.

Hi

I'm just curious to find out when you admit patient with trach, does your facility make sure all the trach supplies are ready like, trach mask, tubings, inner cannulas, obturator before patient is admitted or does your facility expect hospitals or whatever facility patient is transferred from to send enough supplies and wait unitil patient is admitted and order them and where?

[Ms.RN]

we all know what the right answer is to this question.

btdt.

so what is the right answer???? i had a new patient with trach from the hospital and respiratory therapist came and set up his trachs like compressor, humidifier, tach mask, tubing, suctioning machine. other than that he had no other supplies like extra inner cannula, no obturator. a nurse manager stated that hosptial where he came from are suppose to send extra supplies when patient was being tranferred. she also stated becuase we dont have these things, if something happens then i am to send patient to the hospital. welll he pulled his trach tube out and i had to send him out. is this acceptable???

[HiHoCherry-O]

As Tewdles mentioned, the case manager should coordinate with the receiving facility what the patient has and what the patient will need. In my experience, a liasion from the receiving facility will come and see the patient first before accepting into the facility to make sure the patient is appropriate to go to that facility and that the facility can meet the needs of the patient.

It is not the hospitals responsibility to supply other facilities (unaffiliated) with supplies, just as it is not the hospitals responsibility to send patient's to their private home with supplies i.e. shower bars, raised toilet seats, lifts, oxygen etc. This is to be arranged with businesses that provide this as their service, i.e. oxygen company, pharmacy, medical supply store, home health nurse etc.

It sounds like you did what you had to do. Was the patient dependent on a ventilator?