PATIENT CARE IN THE POSTOPERATIVE PERIOD OF A TRACHEOSTOMY CONFECTION: A SCOPING REVIEW PROTOCOL
Creators: name: Pitzer, Monique
name: Flores, Paula
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: Nursing
subject: FOS: Health sciences

description: Tracheostomy is a stoma that connects the trachea to the external environment through a prosthesis, thus allowing the respiratory process1,2. It may be temporary in the case of patients connected to the artificial ventilator, or permanent in the case of oncology surgeries2. Among its numerous indications1, head and neck cancer which includes cancers in the oral cavity, nasal cavity, thyroid gland and larynx is closely related to the confection of permanent tracheostomies. It is estimated for Brazil that each year of the 2020-2022 triennium, 625 thousand new cases of cancer will occur, with a total of 6,470 men and 1,180 women expected to have larynx cancer3. Tracheostomy is a process that has consequences such as changes in body image, changes in the process of breathing and eating4. Such changes are complex in the lives of patients, since they need to adapt to the new reality experienced, requiring the help of the nursing professional in this process, acting in the face of health education and self-care guidance. Although tracheostomy is an millennial procedure5, frequently performed in general and oncology hospitals, there is also a weakness in the process of providing appropriate care to patients and family members in the perioperative period. A study identified as the main nursing diagnoses for patients in the postoperative period of laryngectomy with tracheostomy the Risk of Aspiration, Risk of Infection, Risk of Impaired Skin Integrity, Impaired Tissue Integrity, Hyperthermia, Acute pain, Impaired swallowing, Anxiety and Impaired Verbal Communication6. Among such diagnoses, it was observed that they are mainly related to organic changes, ranging from the impairment of physiological aspects, with permanent tracheostomy, to the impact on social interaction, due to definite loss of voice6. The patient and family member need to be empowered as for the surgical procedure and postoperative care to have a successful recovery, it is necessary that assistance to these patients is provided by nurses with qualified skills and abilities7. Guidelines related to personal hygiene, food care, cannula cleaning and stoma care8, facilitate patient and family adaptation to changes, making them a participant in their health and disease process9. The tracheostomization process requires continuous educational practices in all preoperative and postoperative periods, considering the limits and needs of the patient and family9. The nurse has a fundamental role as an educator in this context, encouraging the patient and the family to assume self-care during the discharge process to the home. It is known that patients who do not receive the necessary information clearly, at the time of hospital discharge, can lead to an unplanned readmission to the hospital in up to a month, which can be pointed out as a weakness of the health team9,10. Among the common causes of readmission include the lack of self-care skills and the lack of knowledge, causes that can be prevented10, through adequate and standardized nursing guidelines for the tracheostomized patient and his family. Given the above, there is a need to map scientific productions about patient care in the postoperative period of a tracheostomy confection during the discharge process to their home. The Scope Review will be part of the dissertation of the Professional Master's Degree in Nursing Assistance of the Postgraduate Program in Nursing, at Universidade Federal Fluminense, entitled “Transitional care for tracheostomized patients: Elaboration of a protocol”.