Real-Life Scenarios in a Safe Learning Environment: Pediatric Tracheostomy Care Simulation

From October 2019 to October 2020, a tracheostomy care simulation program was implemented in a large pediatric tertiary care hospital. Caregivers completed a pre- and post-program survey in which they scored 9 statements on a 5-point scale about their knowledge, confidence and comfort level in caring for their child at home. Accidental tracheostomy tube dislodgement, tracheostomy tube blockage, cardiac arrest, and ventilatory failure were among the emergency scenarios. Classes were recorded for objective start-to-finish scenario timestamps and high rates. A medical assessment was then performed 90 days after discharge. A total of 18 caregivers of 10 children participated in the study. The mean total score agreement for the 10 youth increased by 9.1% from pre- to post-survey, with scores ranging from “agree” to “strongly agree” (P=0.001). After participation, each subset of questions significantly increased scores: knowledge, P=.002, confidence, P=.006, and comfort, P=.01. For the next phase in the scenario, the caregivers needed an average of 20% urgent care. Children were 70% female, 80% Caucasian, and 60% had public insurance, with a median age of 4 months when their tracheostomy tube was implanted (range, 0 months to 24 years). Within 90 days of being sent home, 3 children (n=3/9 [33.3%]) were readmitted for tracheitis. Participation increased the knowledge, confidence and comfort level of the caregiver. Because tracheostomy patients were medically frail, health care providers needed to be aware of and prepared for common tracheostomy crises and ‘hands-on’ emergency scenarios.

Source –rc.rcjournal.com/content/67/1/40