From October 2019 to October 2020, a tracheostomy care simulation program was implemented in a large tertiary care children’s hospital. Pre- and post-program surveys were completed by caregivers. They scored 9 statements on a 5-point scale that measured their knowledge, confidence, comfort level, and ability to care for their child at-home. The emergency scenarios included accidental tracheostomy tubes dislodgement and tracheostomy tub blocking, cardiac arrest, ventilator failure, and ventilator failure. Classes were recorded for objective start-to-finish scenario timestamps and fast rates. A medical chart review was then done 90 days after discharge. The research involved the participation of 18 caregivers caring for 10 children. The average total score agreement for the 10 youngsters increased by 9.1% from pre to post-survey, with scores moving from “agree” to “strongly agree” (P=.001). Participation in each subset of questions resulted in significantly higher scores: knowledge. P=.002, confidence, PComfort: P=.01. The next phase of the scenario required that the carers pay a 20% rate per annum. Children were 70% women, 80% Caucasian, 60% had insurance and had a median age 4 months at the time their tracheostomy was placed (range, 0-24 years). Three children were sent home within 90 days (n=3/9) [33.3%]) were readmitted for tracheitis. Participation increased caregiver confidence, knowledge, and comfort levels. Because tracheostomy patients were medically vulnerable, caregivers needed to be aware of and prepared for common tracheostomy crises and “hands-on” emergency scenarios.
Source –rc.rcjournal.com/content/67/1/40
