Effectiveness of protocols on tracheostomy care among staff nurses working in critical care units: a quasi-experimental study

Background: Tracheostomy care requires consistent nursing knowledge and competent practice to maintain airway safety and reduce preventable complications. Standardized protocols can support nurses in performing routine care, stoma care, and suctioning in a consistent manner. Aim: To assess the effectiveness of protocols on tracheostomy care on the knowledge and practice of staff nurses working in critical care units. Methods: A quantitative, quasi-experimental one-group pretest-posttest design was used. Sixty staff nurses working in critical care areas of Narayana General Hospital and Narayana Super Specialty Hospital, Nellore, were selected by non-probability convenience sampling. Knowledge was assessed using a 35-item self-administered questionnaire and practice using a 20-item observational checklist. The tracheostomy care protocol addressed routine care, stoma care, and suctioning. Pretest assessment was followed by protocol teaching and demonstration, and posttest assessment was conducted after 7 days. Descriptive statistics, paired t-test, Karl Pearson correlation, and chi-square test were used. Results: The mean knowledge score increased from 21.01±6.79 in the pretest to 28.90±3.80 in the posttest (paired t=7.89, df=59, p<0.05). The mean practice score increased from 10.90±4.70 to 15.70±2.80 (paired t=6.80, df=59, p<0.05). In the posttest, 76.6% of nurses had adequate knowledge and 81.7% demonstrated good practice. The reported posttest correlation between knowledge and practice was strong (r=1.00). Conclusion: The findings indicate that protocol-based teaching and demonstration were associated with significant improvement in nurses’ knowledge and practice of tracheostomy care. Standardized tracheostomy care protocols may be useful as part of continuing nursing education and critical-care practice.