Tracheostomy care program descriptive studies.

Tracheostomy is a lifesaving, essential procedure performed for airway obstruction in the case of head and neck cancers, prolonged ventilator use, and for long-term pulmonary care. While successful quality improvement interventions in high-income countries such as through the Global Tracheostomy Collaborative significantly reduced length of hospital stay and decreased levels of anxiety among patients, limited literature exists regarding tracheostomy care and practices in low and middle-income countries (LMIC), where most of the world resides. Given limited literature, this scoping review aims to summarize published tracheostomy studies in LMICs and highlight areas in need of quality improvement and clinical research efforts. Based on the PRISMA guidelines, a scoping review of the literature was performed through MEDLINE/PubMed and Embase using terms related to tracheostomy, educational and quality improvement interventions, and LMICs. Publications from 2000–2022 in English were included. Eighteen publications representing 10 countries were included in the final analysis. Seven studies described baseline needs assessments, 3 development of training programs for caregivers, 6 trialed home-based or hospital-based interventions, and finally 2 articles discussed development of standardized protocols. Overall, studies highlighted the unique challenges to tracheostomy care in LMICs including language, literacy barriers, resource availability (running water and electricity in patient homes), and health system access (financial costs of travel and follow-up). There is currently limited published literature on tracheostomy quality improvement and care in LMICs. Opportunities to improve quality of care include increased efforts to measure complications and outcomes, implementing evidence-based interventions tailored to LMIC settings, and using an implementation science framework to study tracheostomy care in LMICs.

气管造口术是一项挽救生命的关键手术，适用于头颈部癌症导致的气道梗阻、长期机械通气需求，以及长期肺部护理场景。尽管在高收入国家，通过全球气管造口协作组（Global Tracheostomy Collaborative）开展的成功质量改进干预措施已显著缩短患者住院时长、降低其焦虑水平，但针对全球多数人口所在的低收入和中等收入国家（Low and Middle-Income Countries，LMIC）的气管造口护理与临床实践的相关文献仍较为匮乏。鉴于相关文献的稀缺性，本范围综述旨在汇总已发表的LMIC地区气管造口术相关研究，并明确亟需开展质量改进与临床研究的方向。本研究遵循PRISMA（系统评价与Meta分析优先报告条目）指南，通过MEDLINE/PubMed及Embase数据库，以气管造口术、教育与质量改进干预措施、LMIC为检索词开展了范围综述。纳入2000年至2022年间发表的英文文献，最终共纳入覆盖10个国家的18篇文献用于分析。其中7项研究阐述了基线需求评估，3项研究开发了照护者培训方案，6项研究对家庭或医院环境下的干预措施开展了试验，另有2篇文献探讨了标准化护理规程的制定。总体而言，相关研究凸显了LMIC地区气管造口护理面临的独特挑战，包括语言与读写能力障碍、资源可及性问题（如患者家庭的自来水与电力供应情况），以及医疗系统可及性障碍（如出行与随访产生的经济成本）。目前，LMIC地区关于气管造口术质量改进与护理的已发表文献仍较为有限。提升护理质量的可行路径包括：加大并发症与结局指标的评估力度、推行适配LMIC地区场景的循证干预措施，以及运用实施科学框架开展LMIC地区气管造口护理相关研究。