Affiliations: [a] NeuroRehabilitation Unit, Department of Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland | [b] Department of Surgery and Anesthesiology, Department of Intensive Care and Emergency, University Hospital of Lausanne (CHUV), Lausanne, Switzerland | [c] Neurosurgery, Department of Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland | [d] Department of Oto-Rhino-Laryngology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland | [e] Institute of Social and Preventive Medicine, University Hospital of Lausanne (CHUV), Lausanne, Switzerland | [f] Physiotherapy, University Hospital of Lausanne, Lausanne, Switzerland | [g] Phoniatry Unit, Department of Oto-Rhino-Laryngology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
Correspondence:
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Address for correspondence: M. Loric Berney, Neurorehabilitation Unit, Department of Clinical Neurosciences (BH/13/545), Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
Tel.: +41 79 556 6478/21 314 95 87; E-mail: Loric.Berney@chuv.ch
Abstract: Background/purpose:A new coordinated interdisciplinary unit was created in the acute section of the department of clinical neurosciences, the Acute NeuroRehabilitation (NRA) unit. The objective was to evaluate the impact of the unit and its neurosensory programme on the management of tracheostomy patients in terms of reduction in the average time taken for weaning, weaning success rate and therapeutic efficiency. Methods:This 49-month retrospective study compares 2 groups of tracheostomy patients before (n = 34) and after (n = 46) NRA intervention. The outcome measures evaluate the benefits of the NRA unit intervention (time to decannulation, weaning and complication rates) and the benefits of the coordination (time to registration in a rehabilitation centre and rate of non-compliance with standards of care). Results:Weaning failure rate was reduced from 27.3% to 9.1%, no complications or recannulations were observed in the post-intervention group after weaning and time to decannulation following admission to our unit decreased from 19.13 to 12.75 days. The rate of non-compliance with patient standards of care was significantly reduced from 45% to 30% (Mann-Whitney p = 0.003). Discussion/conclusions:This interdisciplinary weaning programme helped to reduce weaning time and weaning failure, without increased complications, in the sample studied. Coordination improved the efficiency of the interdisciplinary team in the multiplicity and complexity of the different treatments.
