Impact of Implementing a Trach Education Specialist in the Pediatric Population

Abstract

Background: The pediatric population has a long history with trach-dependent patients. Families often need education before taking their trach-dependent child home. The bedside respiratory therapists (RTs) have been responsible for educating families about their child’s trach. This process was not streamlined. Trach education was inconsistent. A house-wide trach collaborative committee (TCC) was formed, and consistent educational resources have been made available with easier access. The TCC and the RT dept determined the next step would be to create a position for a trach education specialist (TES). This position is full-time and duties for this position include teaching trach families about the trach so they will be prepared to take their child home. The TES serves as a clinical expert to help the bedside RTs answer questions and assist families with their child’s trach needs.

Methods: The purpose of the study is to compare pre and post implementation of the TES position. A Likert scale survey was sent out to the RT dept prior to the TES position to understand the baseline knowledge and what areas of concern could be improved, if any. Once the areas of concern are identified then interventions would be implemented to target the needs. The objective was to compare if the TES is beneficial to the RT department and, more specifically, to the clinical RTs who encounter trachs frequently. After the TES position was established and fully functioning another survey was sent out to the clinical RTs to measure the impact of the TES.

Results: The areas of concern included the comfort level of the bedside RTs, locating reference materials, caring for a fresh trach and mature trach, and educating family on trach care. We also focused on increasing awareness on how to contact the TES and TCC. The interventions implemented to increase awareness of the TES were an email introduction to staff, TES on volate, and contact information listed on TCC webpage. The TES engages with staff and self-promotes the role.

Conclusions: The RTs have tremendously benefited from the TES. There was a 16% increase in the awareness of where to locate reference materials. When caring for a fresh trach we noticed a 27% increase in knowledge and comfort level of teaching. RTs’ comfort level in teaching families about a mature trach increased by 23%. Discharge education comfort level increased by 27%. Awareness of how to contact the TES increased by 16%. An increase of 42% on how to find the TCC webpage. Well over half of our clinical staff now use the TES during their shifts.