Development of safety protocols for managing thirst in post-extubated and tracheostomized patients

Abstract

Objective: to develop two distinct protocols, based on evidence, with safety criteria for post-extubated and tracheostomized patients in order to support the administration of thirst relief methods. Method: methodological study divided into two phases: definition of the scope and development of the protocols. Safety criteria were identified and submitted to the evaluation of reliability of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADEpro) system. The criteria were incorporated into flowcharts with their respective operational manuals. The Experts formulated recommendations and the Content Validity Index was calculated. Results: two protocols and its respective manuals were developed to assess the safety of the administration of thirst relief methods: one for post-extubated patients and the other for tracheostomized patients. Safety criteria listed: level of consciousness, signs of respiratory failure, nausea and/or vomiting, swallowing ability, coughing/airway protection, voice changes and adequate functioning of the tracheostomy tube. The Experts’ recommendations were obtained with a Content Validity Index of 87%. Conclusion: the clinical protocols, with six safety criteria each, based on evidence for the management of thirst in post-extubated and tracheostomized patients are innovative, allow safety assessment for thirst management and shows content validity.