From October 2019 to October 2020, a tracheostomy care simulation program was implemented in a large tertiary care children’s hospital. Caregivers completed a pre-and post-program survey in which they scored 9 statements on a 5-point scale about their knowledge, confidence, and comfort level in caring for their child at home. Accidental tracheostomy tube dislodgement, tracheostomy tube blocking, cardiac arrest, and ventilator failure were among the emergency scenarios. For objective start-to-finish scenario time stamps and fast rates, classes were recorded. Then, 90 days after discharge, a medical chart review was undertaken. A total of 18 caregivers for 10 children took part in the research. The average total score agreement for the 10 youngsters increased by 9.1% from pre to post-survey, with scores moving from “agree” to “strongly agree” (P=.001). After participating, each subset of questions substantially increased scores: knowledge, P=.002, confidence, P=.006, and comfort, P=.01. For the next phase in the scenario, the carers needed a 20% fast rate on average. Children were 70% female, 80% Caucasian, and 60% had public insurance, with a median age of 4 months when their tracheostomy tube was implanted (range, 0 months to 24 years). Within 90 days of being sent home, 3 children (n=3/9 [33.3%]) were readmitted for tracheitis. Participation raised caregiver knowledge, confidence, and comfort levels. Because tracheostomy patients were medically vulnerable, caregivers needed to be aware of and prepared for common tracheostomy crises and “hands-on” emergency scenarios.


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