Clinical Outcomes and Nursing Strategies for Paediatric Tracheostomy Children: A Prospective Observational Study of 150 Cases

BACKGROUND: This study aimed to analyse clinical outcomes of children post-tracheostomy and to explore effective nursing strategies. METHODS: A prospective observational study was conducted from January 2020 to December 2022, including 150 children who underwent tracheostomy. They were further divided into airway obstruction and lung support groups based on the tracheostomy indication. Post-discharge, preferably children requiring prolonged mechanical ventilation (PMV) received either respiratory therapist-led or home-based continuity care, with outcomes compared between the two. RESULTS: A total of 150 children were categorised into PMV (n = 91) and non-PMV (n = 59) based on the duration of mechanical ventilation. The PMV group had more patients under 5 years old and fewer cases of airway obstruction (p = 0.001). Preferably children requiring PMV had higher mortality in the first month post-discharge and higher adverse reaction rates during hospitalisation (p = 0.004), with longer hospital stays (p < 0.001). No significant difference in one-month post-discharge mortality was found between the two indication groups, but airway obstruction patients had lower one-year post-discharge mortality (p = 0.008) and shorter hospital stays (p = 0.034). Respiratory therapist-led continuity care significantly reduced re-admission and rehospitalization rates (p = 0.002). CONCLUSION: PMV is prevalent among tracheostomized children and is linked to higher adverse reactions and mortality. Effective nursing strategies, particularly respiratory therapist-led continuity care, are vital for improving long-term outcomes and reducing rehospitalisation rates in preferably children requiring PMV.