191 - Experience and Educational Needs of Hospital Staff Providing Care to Tracheostomy-Dependent Children: A Survey Study

Poster Number: 191
Publication Number: 191.143

Desirae Smith, Golisano Children's Hospital at The University of Rochester Medical Center, Ontario, NY, United States; Kathryn Palumbo, University of Rochester School of Medicine and Dentistry, Rochester, 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: Limited clinical and educational opportunities can hinder pediatric healthcare professionals from developing the necessary expertise to care for children with tracheostomies (trachs) and prepare caregivers for a safe transition from the hospital-to-home environment.

Objective: To assess the experience and educational needs of healthcare professionals who care for children with tracheostomies in the hospital setting.

Design/Methods: In 2021, we conducted a survey study of hospital staff who provide care to trach-dependent children in the neonatal, pediatric and pediatric cardiac intensive care units. An interprofessional team with expertise in the care of these children developed and piloted the survey using an iterative process. The final survey consisted of 13 questions using Likert scale ratings, multiple options and open-text responses that were administered via REDCap. Questions focused on staff experience, confidence and educational needs to care for and provide support to caregivers of trach-dependent children. Data were analyzed using the Kruskal Wallis nonparametric test and descriptive statistics.

Results: A total of 152/353(43%) eligible staff completed the survey: 5 advanced practice providers, 115 nurses, 23 physicians, 9 respiratory therapists. Staff ranged in their years of experience working with trach-dependent children. While 76% provided care for a trach-dependent child within the last year, 38-59% did not perform a variety of trach skills (Figure). Skills that even the most experienced staff reported the least confidence in performing included changing the trach tube, using a home ventilator, and responding to alarms on a home ventilator (Table 1). Staff rated these skills as most important for additional education (Table 2). They also desired education on how to train caregivers (Table 2). In open-ended responses, staff expressed the need for simulations in general trach care and handling emergencies. They indicated a need to streamline the discharge process, gain knowledge of home and community resources, and develop a standardized team to provide discharge teaching.Conclusion(s): Pediatric healthcare professionals responsible for providing care to trach-dependent children in the hospital setting ranged in experience and have limited ongoing clinical opportunities to learn and maintain their skills. When used as part of a needs assessment, these survey results aid in the development of continuing professional education to optimize the care of trach-dependent children and provide support to their caregivers.
FigureThe Last Time Staff Performed Specific Tracheostomy Skills
Table 1Staff Confidence Performing Tracheostomy Skills