Nursing Skills in the Care of Patients With Respiratory Stomas in Hospitals With and Without Advanced Practice Tracheostomy Service

J Clin Nurs. 2025 Jan 14. doi: 10.1111/jocn.17655. Online ahead of print.

Abstract

Aims: To identify whether there are differences in knowledge regarding the management of patients with respiratory stomas among nurses working in hospitals with an advanced practice tracheostomy service compared to those without it.

Design: Descriptive, cross-sectional, comparative, analytical survey study.

Method: The study was conducted from January to March 2023 in four tertiary care hospitals, two of which have an advanced practice tracheostomy service. A self-administered questionnaire was designed, consisting of 16 questions about nurses' specialised training in caring for tracheostomy patients. The study adhered to the STROBE checklist. Statistical analyses were performed using SPSS (24.0) from IBM.

Results: Nurses in hospitals with a dedicated tracheostomy service obtained a higher mean score (7.1/10) and demonstrated greater anxiety when managing patients with stomas (p < 0.001), as well as an increased willingness to undergo specific training (p = 0.017) to reduce their lack of self-confidence.

Conclusions: A higher level of anxiety in the management of tracheostomised patients and a greater interest in receiving specific training have been observed among nurses in hospitals with advanced practice services (APTS), despite having greater training. Therefore, institutions should commit to incorporating advanced practice nurses and continuing education in the approach to ostomies among their professionals.

Implications for the profession and/or patient care: Implementing ongoing training programmes and specific tracheostomy services or units in hospitals would enable nurses to provide high-quality care for patients with respiratory stomas.

Reporting method: The study adhered to the STROBE checklist.

Patient or public contribution: Neither patients nor the public were involved in the design or conduct of this research. Nurses participated exclusively in data collection.

Keywords: nursing care; patient care team; professional training; surgical stomas; tracheostomy.