Enhancing RN Confidence in Tracheostomy and Mechanical Ventilation Care

Abstract

Background: The Respiratory Acute Care Unit (RACU) is a 12-bed intensive care unit specializing in weaning patients from prolonged mechanical ventilator support. Education for RNs about the care for patients with tracheostomy tubes and invasive and noninvasive mechanical ventilation has been delivered mainly by nurses during hospital orientation or the new graduate RN residency program. Due to the specialized care needs of these patients, we developed a 4-h course to increase the confidence of new RNs orienting to the RACU.

Methods: Eleven RNs participating in the RACU new hire orientation program were asked to complete a 25-question survey (SurveyMonkey) to assess their confidence in caring for tracheostomized and mechanically ventilated patients. A Likert-Scale 1 (not at all confident) to 5 (very confident) was used. The RNs then attended a 4-h course focusing on tracheostomy tubes and mechanical ventilation. RNs were asked to complete the same survey to assess their learning. The post-survey also asked 3 open-ended questions to collect feedback from the participants. Statistical analysis was performed using Stata/SE 17.0 for Windows (StataCorp, College Station, TX). Descriptive statistics were used to describe the demographic data. The Shapiro-Wilk test was employed to assess the normality of the data distribution. A paired samples t-test was used to determine if there was a significant difference in the mean values between the pre- and post-survey results. The open-ended questions on the post-survey were analyzed for themes by the primary investigator.

Results: Six RNs completed the pre-and post-survey. The mean difference between the pre (2.59 ± 1.3SD) and post (3.71 ± 0.9) survey scores was 1.12 ± 1.0SD. There was a significant increase in confidence (P < .001) between the pre- and post-survey scores. For the open-ended questions, there were several themes identified. Subjects appreciated the hands-on and practical components of the training, suggested scheduling these sessions earlier, and desired more detailed emergency response training.

Conclusions: Implementing a focused 4-h course for new RNs in the Respiratory Acute Care Unit (RACU) significantly enhanced their confidence in managing patients with tracheostomy tubes and mechanical ventilation. Overall, the specialized training course successfully addressed the unique educational needs of the RACU staff, leading to better-prepared nurses capable of providing high-quality care to this complex patient population.

• Download figure
• Open in new tab
• Download powerpoint