Implementation of an Online Multimedia Pediatric Tracheostomy Care Module for Healthcare Providers

Abstract

Objectives/Hypothesis: To investigate the effect of a multimedia educational module on provider attitudes toward pediatric tracheostomy care. We also describe the process of module development and dissemination at an academic children's hospital.Study Design: Prospective observational study. Methods: The pediatric airway committee at an urban tertiary care center developed a multimedia pediatric tracheostomy care module. Nurses, respiratory therapists, as well as resident, fellow, and attending physicians caring for pediatric patients with tracheostomies were eligible. Managers and clinical supervisors from various units recruited participants to complete the pediatric tracheostomy care electronic module and pre-and postassessment knowledge quizzes and surveys. Provider confidence was analyzed using Kruskal-Wallis H-test and Mann-Whitney U-test, and paired t-test was used to compare pre-and postmodule quiz scores.Results: A total of 422 participants completed the module. A total of 275 participants completed the premodule survey, 385 completed the premodule quiz, 253 completed the postmodule survey, and 233 completed the postmodule quiz. Participants included providers in the neonatal intensive care unit, pediatric intensive care unit, pediatric emergency department, and pediatric wards. Postmodule surveys demonstrated a significant reduction in the average percentage of participants indicating lack of confidence with regards to changing an established tracheostomy, responding to accidental decannulation of established tracheostomy, and responding to accidental decannulation of fresh tracheostomy (P < .001). Average quiz scores increased by 5.6 points from 83.0% to 88.6% (P < .00001).Conclusions: A multimedia educational module can improve provider perception of their knowledge and confidence surrounding pediatric tracheostomy management.

Emergency management plan for paediatric patients with tracheostomies during the coronavirus disease 2019 pandemic

“…Tertiary hospitals usually have an abundance of resources to help within specific specialty fields, especially during normal working hours; however, even in large academic institutions, care providers can be unfamiliar and lack confidence with regard to tracheostomy management, more so in the paediatric population. 15 This can result in hastily made decisions that, though well-meaning in their intent, may introduce a risk for iatrogenic injuries to the child, and can unnecessarily increase aerosol generation, thereby potentially exposing healthcare workers.…”

Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations

“…5,6 Multiple surveys of non-otolaryngologist health care providers have demonstrated knowledge gaps and discomfort with tracheostomy care. [7][8][9][10] In response, educational programs including simulation training have demonstrated improvement in health care providers' [11][12][13][14][15] and caregivers' 16 knowledge, skills, and comfort with tracheostomy management. Hands-on nursing skills training programs have also been associated with decreases in severe complications 17,18 and ICU readmissions 19 in adult patients with tracheotomies.…”

“…[30][31][32][33][34][35] Furthermore, the in situ setting recreates complex systems to detect latent safety threats (systems flaws which have the potential to combine to cause harm to patients and staff), [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] train interprofessional teams 36,37,[50][51][52][53][54][55] and implement novel protocols. 41,[56][57][58] Although simulation has been employed as a quality improvement tool to identify systems errors pertinent to pediatric tracheostomy emergency management, 11,39,40 the lack of validated assessment tools for team performance 58 in response to a pediatric tracheostomy crisis scenario limits comparison of units and hospitals to one another and measurement of the effectiveness of interventions on tracheostomy emergency readiness. Remick et al developed a survey 59 assessing pediatric emergency department readiness nationally and correlated these scores with clinical outcomes 60 ; however, tracheostomy emergencies were not specifically addressed in their pediatric readiness survey.…”

“…Although simulation has been employed as a quality improvement tool to identify systems errors pertinent to pediatric tracheostomy emergency management, 11,39,40 the lack of validated assessment tools for team performance 58 in response to a pediatric tracheostomy crisis scenario limits comparison of units and hospitals to one another and measurement of the effectiveness of interventions on tracheostomy emergency readiness. Remick et al developed a survey 59 assessing pediatric emergency department readiness nationally and correlated these scores with clinical outcomes 60 ; however, tracheostomy emergencies were not specifically addressed in their pediatric readiness survey.…”