Abstract
Background: Children with a tracheostomy (trach) with/without ventilator dependency are one of the most medically fragile and high-risk patient populations. Practices for their care should be consistent throughout different areas of a healthcare organization. Nurses and respiratory therapists who provide bedside care for these children must remain proficient in trach care procedures. When a child with a trach is assigned to an area where staff are not as comfortable or accustomed to providing routine trach care, this can potentially present safety concerns. We hypothesize that a multimodal educational intervention will increase healthcare providers' knowledge and comfort of trach management.
Methods: Registered nurses and respiratory therapists at one children’s hospital were invited to anonymously complete a survey regarding knowledge and comfort in caring for trach-dependent children. A 5-point Likert scale was used to evaluate comfort related items. Educational interventions including a presentation and instructional videos for trach skills were provided later. The survey was repeated 6 months following the interventions to evaluate change in staff comfort and knowledge. Data were compared with Mann-Whitney test. Descriptive statistics were used to summarize results. P< .05 was considered significant.
Results: There were 275 and 142 respondents in the pre and post groups, respectively. The majority of respondents were nurses and did not work in an ICU or designated ventilator ward (62% pre, 56% post). Staff comfort was significantly increased in caring for the trach-dependent child (P = .03), trach and ventilator-dependent child (P = .03), routine trach care (P = .02), routine trach tube change (P = .005), and emergency trach tube change (P = .01). Knowledge of how to access educational resources improved (48% pre, 68% post). Staff knowledge for the number of required trained caregivers was essentially unchanged (92% pre, 96% post).
Conclusions: Increased comfort was reported for all aspects of care following educational interventions. The targeted educational interventions seemed beneficial in helping nurses and respiratory therapists feel more comfortable in caring for the trach-dependent child. Ongoing education will be necessary to increase knowledge and comfort in performing life-saving maneuvers, including emergency trach change.
Footnotes
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