Abstract
<strong>Objectives:</strong> In standard medical school and residency curricula, there is little formal training in the acute or chronic management of tracheostomies, yet consistent and correct care is critical to prevent and treat complications. The objective of this study was to assess the knowledge and comfort level of non-otolaryngology healthcare providers in the care of adult patients with a tracheostomy. Further, this study evaluated the effectiveness of an easily reproducible 1-hour workshop, employing both didactics and simulation, to enhance comfort and knowledge surrounding care of patients with tracheostomies. <strong>Methods:</strong> Eighty-five participants across different medical specialties, levels of training, and care roles were included in this cohort study. The simulation included three 10-minute stations: 1) understanding the component parts of standard adult tracheostomy tubes, 2) management of a dislodged tracheostomy tube, and 3) management of a patient with a tracheostomy who cannot be ventilated. Participants completed a pre- and post-intervention self-assessment and multiple-choice questionnaire assessing comfort and knowledge. <strong>Results:</strong> The 1-hour workshop increased participants’ comfort and knowledge. For the seven comfort-based questions, the average comfort level increased from 2.24 pre-intervention to 4.09 on a Likert scale (p < 0.001). For the eight knowledge-based questions, the average correct response rate increased from 36% to 69% (p < 0.001). <strong>Conclusions:</strong> In this study, we demonstrated that there are significant knowledge and comfort deficits among non-otolaryngology healthcare professionals caring for patients with tracheostomies. The easily reproducible 1-hour workshop employed may be an effective starting point for improving knowledge of and comfort with adult tracheostomy care.
Highlights
In 2006, 113,653 tracheotomies were performed in the United States on patients aged 18 years or older [1], making the tracheostomy one of the most frequently performed procedures in critically ill patients [2]
It is important that all healthcare workers directly involved in the care of these patients learn to provide proper tracheostomy care
One study assessing 87 primary healthcare providers found that both knowledge and comfort were deficient with regard to tracheostomy management—from basics such as identifying the type of tracheostomy tube to management of a plugged or dislodged tracheostomy tube [5]
Summary
In 2006, 113,653 tracheotomies were performed in the United States on patients aged 18 years or older [1], making the tracheostomy one of the most frequently performed procedures in critically ill patients [2]. One study assessing 87 primary healthcare providers found that both knowledge and comfort were deficient with regard to tracheostomy management—from basics such as identifying the type of tracheostomy tube to management of a plugged or dislodged tracheostomy tube [5] Another descriptive survey study of 70 healthcare workers, including physicians from two teaching hospitals, showed that knowledge of tracheostomy-related emergencies appears to be insufficient among non-otolaryngology healthcare professionals [2]. These deficiencies are not isolated to physicians alone: one cross-sectional study of inpatient nurses found that only 59 of 128 nurses (46%) reported being “totally
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