PEDIATRIC TRACHEOSTOMY CARE: AN EVALUATION OF AN INNOVATIVE COMPETENCY-BASED EDUCATION PROGRAM FOR HOME CARE NURSES

Abstract

SESSION TITLE: Respiratory Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Safe discharge of children with tracheostomy ventilation is reliant on caregivers’ competence to manage these complex patients. To this end, our multidisciplinary group in Toronto collaboratively designed and implemented a standardized competency-based tracheostomy education course for home care nurses. Our aim is to evaluate home care nurse’s immediate and sustained knowledge retention and sense of self-efficacy following completion of the course. METHODS: A randomized controlled trial involving home care nurse participants recruited from one service provider organization. Participants were randomized to either the intervention group, who attended the tracheostomy course, or the control group, who attended an enterostomy and vascular access course. Participants in the control group were offered the tracheostomy course outside the data collection window. Multiple-choice question (MCQ) knowledge assessments and self-efficacy questionnaires were administered to both groups pre course, post course (intervention only) and then at 6 weeks, 3 months, and 6 months for immediate and long-term knowledge retention, respectively. Demographic data and home care nurse experience logs were also collected. RESULTS: 43 participants were recruited with 19 participants in the intervention group and 20 in the control group. Two participants withdrew from each group. The change in mean self-efficacy scores (total score 100) in the intervention group trended higher (mean 15.6, SD 14.8) than the control group (mean 5.8, SD 19.8) (p=0.1) at 6 weeks, was significantly higher in the intervention group (mean 17.6, SD 12.7) than the control group (mean 4.0, SD 17.2) (p=0.01) at 3 months and trended higher (mean 17.2, SD 14.8) than the control group (mean 5.4, SD 24.4) (p=0.1) at 6 months. Notably, the change in mean MCQ scores (total score 20) between the intervention and control group was not significantly different at 6 weeks (intervention mean 1.5, SD 2.4; control mean 1.2, SD 3.2; p=0.8), 3 months (intervention mean 0.6, SD 5.5; control mean 1.9, SD 2.4; p=0.2), or 6 months (intervention mean 0.8, SD 5.3; control mean 1.8, SD 4.1; p=0.3). CONCLUSIONS: Home care nurses who attended the tracheostomy course demonstrated a higher sense of self-efficacy at long-term follow-up. CLINICAL IMPLICATIONS: A standardized competency-based tracheostomy education course for home care nurses can improve perceived self-efficacy and enhance safe discharge of medically complex children requiring invasive home ventilation. DISCLOSURES: No relevant relationships by Munazzah Ambreen, source=Web Response No relevant relationships by Reshma Amin, source=Web Response No relevant relationships by Stephanie Chu, source=Web Response No relevant relationships by Krista Keilty, source=Web Response No relevant relationships by Sandra McKay, source=Web Response No relevant relationships by Cora Mocanu, source=Web Response No relevant relationships by Julia Orkin, source=Web Response No relevant relationships by Jenny Shi, source=Web Response No relevant relationships by Catharine Walsh, source=Web Response