Tracheostomy is performed in Patients with multiple trauma can be liberated from mechanical ventilation rapidly and be transferred out of the ICU in a shorter time (1.). One of the greatest contributions the nurse can make to decreasing costs, length of stay, and mortality in patients with respiratory problems is to implement interventions that will prevent or minimize complication (2). Nursing guidelines is to outline the principles of management for patients with a new or existing tracheostomy for clinicians at the trauma ICU (3).

Aim:

this study was carried out to investigate Impact of nursing practice guidelines for early tracheostomy management in mechanically ventilated trauma patient.

Design:

a quasi-experimental design.

Setting:

trauma ICU at Assiut University Hospitals. patients: A convenience sample of 60 patients in trauma ICU They were divided into two equals group 30 patients for each group–first group which tracheostomy was performed within the first 7 days of initiation of mechanical ventilation and the late tracheostomy group which tracheostomy was performed after 7 days of initiation of mechanical ventilation at any time.

Methods:

Both groups were evaluated daily during the three shifts using nursing guidelines. Assessment of tracheal secretions was done to detect any abnormalities in the amount, color and consistency was assessed every shift. Laboratory investigations (ABGs) were done daily from the 1st day of admission and until the 7th day of the study. Total leukocytes count and serum hemoglobin was done at the time of admission and repeated at the 4th, 7th and when needed. Culture of the respiratory secretions was done twice …