Evidence-Based Nursing Protocols For Preventing Post-Tracheostomy Complications After Pdt: A Systematic Review (2022–2026)

Vollständiger Abstract

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Percutaneous Dilatational Tracheostomy (PDT) is widely used in critically ill patients requiring prolonged mechanical ventilation but remains associated with complications such as infection, bleeding, and airway compromise. Evidence-based nursing protocols are needed to improve patient safety and prevent post-PDT complications. This study aimed to analyze the effectiveness of evidence-based nursing protocols in preventing complications following PDT. A Systematic Literature Review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature searches were performed in PubMed, ScienceDirect, SpringerLink, and Google Scholar for studies published between 2022 and 2026. Of the 665 articles identified, 16 studies met the inclusion criteria and were analyzed using narrative synthesis. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) according to the study design. The findings indicate that the implementation of standardized nursing protocols, care bundles, infection prevention strategies, airway monitoring, and enhanced nurse competency contributes to reducing post-PDT complications. One study reported a lower incidence of surgical site infection in the PDT group compared with the surgical tracheostomy group (3.4% vs. 8.5%). Ultrasound- and bronchoscopy-guided PDT techniques also demonstrated improved procedural safety and reduced complications in several studies. In conclusion, evidence-based nursing protocols have the potential to improve patient safety and reduce post-PDT complications. The implementation of care bundles, standardized practices, nurse training, and supporting technologies should be strengthened in intensive care nursing practice. The review protocol was not registered in PROSPERO, which represents one of the methodological limitations of this study.