{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:16:55Z","timestamp":1788153415079,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001171","name":"Cancer Institute NSW","doi-asserted-by":"publisher","award":["2024\/ECF1513"],"award-info":[{"award-number":["2024\/ECF1513"]}],"id":[{"id":"10.13039\/501100001171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of head and neck cancer (HNC) is rising globally, with patients undergoing extensive surgical resection for advanced disease frequently requiring prophylactic tracheostomy to secure the airway in the early postoperative period. Specialised HNC nurses undertake extended scope tracheostomy procedures, including tube changes and decannulations, yet practice varies widely between institutions and no standardised training framework exists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives<\/jats:title>\n                    <jats:p>To benchmark the roles and responsibilities of specialised HNC nurses in tracheostomy management across Australia, and to explore the facilitators, barriers and enablers of nurse\u2010led extended practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>National mixed\u2010methods study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An online REDCap questionnaire was distributed to nurses with inpatient HNC tracheostomy experience within the past 5\u2009years (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922). A subset participated in semi\u2010structured interviews (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911), analysed using inductive thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most participants were senior metropolitan\u2010based nurses with over 12\u2009years of HNC experience. Nine (41%) performed tracheostomy tube changes and 14 (64%) conducted decannulations. Thematic analysis identified six themes: the central role of the multidisciplinary team; education and patient support; training and skill acquisition; extended scope of practice; challenges to nurse\u2010led management; and benefits of nurse\u2010led management. Skill acquisition was facilitated by mentoring and high\u2010volume exposure; barriers included collegial resistance, equipment access and workload pressures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Specialised HNC nurses report undertaking extended scope tracheostomy procedures across a range of Australian centres, with mentoring, high\u2010volume clinical exposure and multidisciplinary collaboration described as key enablers. Standardised competency frameworks may help to reduce inter\u2010institutional variation; however, the safety, efficiency and patient\u2010level outcomes of these models were not directly evaluated in this study and warrant formal investigation in future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>This study provides the first national descriptive data on the role of nurses in tracheostomy management for patients with HNC in Australia and offers a foundation for the development of standardised training pathways. The potential impact of such pathways on efficiency, length of stay and nursing workforce capacity warrants formal evaluation in future studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70529","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:25:04Z","timestamp":1788150304000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nursing\u2010Led Models of Tracheostomy Management for Patients With Head and Neck Cancer: A Mixed\u2010Methods Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8124-6203","authenticated-orcid":false,"given":"Sarah","family":"Davies","sequence":"first","affiliation":[{"name":"Head and Neck Surgery Chris O'Brien Lifehouse  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Palme","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Chris O'Brien Lifehouse  Camperdown New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faruque","family":"Riffat","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Chris O'Brien Lifehouse  Camperdown New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8246-210X","authenticated-orcid":false,"given":"Emma","family":"Charters","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Chris O'Brien Lifehouse  Camperdown New South Wales Australia"},{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Agency for Clinical Innovation (ACI).2021.\u201cClinical Practice Guide: Care of Adult Patients in Acute Care Facilities With a Tracheostomy.\u201dhttps:\/\/aci.health.nsw.gov.au\/__data\/assets\/pdf_file\/0004\/685300\/ACI\u2010CPG\u2010Care\u2010adult\u2010patients\u2010acute\u2010tracheostomy.pdf."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.17601"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1186\/s12912-022-01101-y","article-title":"Assessment of the Ability, Perception, and Readiness of Nurses to Manage Tracheostomy\u2010Related Complications in Riyadh City: A Cross\u2010Sectional Study","volume":"21","author":"Alotaibi F. 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