192 - Exploring experiences and educational needs for healthcare professionals caring for pediatric patients with a tracheostomy tube: a qualitative study

Poster Number: 192
Publication Number: 192.143

Kathryn Palumbo, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Desirae Smith, Golisano Children's Hospital at The University of Rochester Medical Center, Ontario, NY, United States; Adrianne Frankel, Golisano Children's Hospital at The University of Rochester Medical Center, Pittsford, NY, United States; Laine E. DiNoto, Golisano Children's Hospital at The University of Rochester Medical Center, Rochester, NY, United States; Kimberly Buholtz, Golisano Children's Hospital at The University of Rochester Medical Center, West Henrietta, NY, United States; Christina Dalo, Golisano Children's Hospital at The University of Rochester Medical Center, Rochester, NY, United States; Taylor Wheaton, Golisano Children's Hospital at The University of Rochester Medical Center, Syracuse, NY, United States; Rita Dadiz, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States

Background: While there is an increasing number of infants and children with tracheostomies (trachs), most healthcare professionals have limited experience caring for these patients and educating their caregivers. Many intensive care units are responsible for discharging a child with a trach tube home, and it is important to understand the challenges and special considerations caring for these patients while supporting and educating their caregivers. There are limited studies that describe healthcare professionals’ experiences, learning needs, and preparedness to train caregivers of children with a trach to transition home.

Objective: To identify healthcare professionals’ experiences, confidence, and knowledge gaps in caring for children with a tracheostomy tube and preparing caregivers to take their child home.

Design/Methods: In 2021, we conducted a single center, qualitative study of interviews and focus groups of pediatric advance practice providers, nurses, physicians and respiratory therapists from the neonatal, pediatric and pediatric cardiac intensive care units who care for patients with a tracheostomy tube. We analyzed transcripts using grounded theory until reaching thematic saturation. We identified and verified emergent themes and subthemes.

Results: We attained thematic saturation after 43 pediatric staff participated in 10 interviews and focus groups (Table 1). Five main themes emerged, highlighting the most significant challenges staff experience caring for children with tracheostomies while supporting their caregivers (Table 2): 1) variable skills and lack of expertise due to limited in-hospital experience, 2) limited-to-no training before clinical care nor ongoing skills maintenance, 3) lack of standardized educational pathway for staff as trainers and caregivers as learners, 4) limited knowledge of helping caregivers navigate their home environment and community resources, and 5) variable experiences related to caregiver engagement.Conclusion(s): Pediatric healthcare professionals highlighted some significant challenges that staff experience in caring for children with tracheostomy tubes. When used as part of a needs assessment, these challenges stressed the need for continuing professional education to optimize the care of trach-dependent pediatric patients, while supporting caregiver learning and education.
Table 1. Participant Demographics
Focus Group Excerpts Representing the Five Major Themes