East Surrey Hospital, Surrey, UK
Northwick Park Hospital, London, UK
Charing Cross Hospital, London, UK
A. Hariri, Department of ENT Surgery, Northwick Park Hospital,
Watford Rd, Harrow HA1 3UJ, UK.
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Accepted: 13 September 2017
Reduction in harm from tracheostomy-related incidents after
implementation of the paediatric National Tracheostomy
Safety Project resources: A retrospective analysis from a
tertiary paediatric centre
In the UK, patient safety issues related to adult tracheostomies are
well recognised. A number of reports from the National Patient Safety
Agency and National Confidential Enquiry into Patient Outcome and
Death highlighted recurrent themes with deficiencies in staff educa-
tion, resources, equipment provision and emergency guidance.
Similar patient safety concerns exist in the paediatric population.
Studies report overall mortality rates in paediatric patients with tra-
cheostomies varying from 2.2%
fic mortality is lower at 0.9%
Within our institution, concerns
were noted regarding the risk of serious avoidable tracheostomy mor-
bidity after merging three paediatric hospitals onto a single site in 2009.
Similar concerns regarding paediatric tracheostomy safety exist
nationally. In response, the Paediatric Working Party of the National
Tracheostomy Safety Project (NTSP) was established in 2014. Col-
laborators include health care professionals from multidisciplinary
specialties: Paediatric Otolaryngology, Paediatric Anaesthesia, Paedi-
atric Intensive Care, Speech and Language Therapists, Tracheostomy
Nurse Specialists, Physiotherapists and Resuscitation Practitioners
from across the UK and Ireland. The aims of the Working Party are
to reduce morbidity and mortality in children living with a tra-
This reflects the NTSP adult work
with publication of
emergency guidelines and comprehensive resources, the implementa-
tion of which resulted in a reduction in the frequency and severity
of tracheostomy incidents.
This study aimed to evaluate the impact of implementing tra-
cheostomy-related guidelines and a number of other local interven-
tions as a bundle of care by retrospectively examining the reported
tracheostomy-related patient safety incidents reported between
2010 and 2015 at a single tertiary paediatric centre.
The study was performed using a retrospective review of anon-
ymised clinical data, and institutional approval was granted.
CORRESPONDENCE: OUR EXPERIENCE