Safe Chest Tube Securement
Care Process & Redesign
Yishun Health One Improvement Festival
National Healthcare Group
8 April 2025
The objective is to develop an effective chest tube dressing that is safe, easy to apply, hypoallergenic, non-bulky. The new chest tube dressing with Tegaderm IV advanced dressing was approved and standardized in KTPH, with ongoing monitoring and.
Year Submitted: 2025
Published Date: 08 April 2025
Tags: Quality Improvement, Workflow Redesign, Cost Saving, Productivity, Clinical Practice Improvement, Design Thinking, Value Based Care, Safe Care, Product Development, Care Process ＆ Redesign
About this Content
Aims
The objective is to develop an effective chest tube dressing that is safe, easy to apply, hypoallergenic, non-bulky, transparent for direct observation, and cost-effective.
Background
Accidental chest tube dislodgement is one of the most common complications associated with chest tube placement, increasing healthcare costs and compromising patient safety, comfort, and recovery. At Khoo Teck Puat Hospital, the significant number of chest tube dislodgement cases each year has raised concerns about the quality and safety of chest tube management.
Methods
The team conducted a detailed root cause analysis of current practice of chest tube care from the insertion to patient bedside. Various possible root causes were derived and concluded by historical data extracted from the PRISM system. Direct observation was also made by simulation of chest tube dislodgement. The team brainstormed for countermeasures based on evidence of best practice and existing creative ideas.
Results
From 4.8.23 - 4.1.24, 32 patients of the pilot wards had used Tegaderm IV Advanced chest tube dressing. Outcomes monitored showed zero incidents of chest tube dislodgement and zero adverse effects during trial implementation.
Conclusion
The new chest tube dressing with Tegaderm IV advanced dressing was approved and standardized in KTPH, with ongoing monitoring and improvement efforts.
Lessons Learnt
The traditional chest tube dressing was modified and simplified using Tegaderm IV Advanced and Durapore, meeting all essential criteria for an effective chest tube dressing while significantly reducing chest tube dislodgement.
Additional Information
Ongoing review and improvement via updates at nursing quality meetings and nursing leader meetings for engagement and sharing of success in reducing chest tube dislodgement in KTPH.
Keywords
Chest Tube, Dislodgement, Nursing, Patient Safety, Cost-Effective
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | Yishun Health One Improvement Festival |
Healthcare Professional Group(s) | Nursing, Medical |
Applicable Specialty or Discipline | General Medicine, Respiratory Therapy, Pulmonology |
Project Lead(s) | Toh H.M. |
Project Member(s) | Joyce Ho Nuo |
Connect with this contributor!
KTPH & YCH Innovation & Improvement (I&I) Office - i-i@ktph.com.sg