Real-life scenarios in a safe learning environment: Simulation of pediatric tracheostomy care

From October 2019 to October 2020, a tracheostomy care simulation program was implemented at a third major pediatric hospital. The participants conducted a pre- and post-program survey in which they received 9 statements on a 5-point scale about their knowledge, confidence, and level of comfort in caring for their child at home. Emergency scenarios included accidental placement of tracheostomy tubes, closure of tracheostomy tubes, cardiac arrest, and fan failure. For time seals of the objective scenario from start to finish and speed, lessons were recorded. After 90 days of leave, a medical schedule review was conducted. A total of 18 tutors from 10 children participated in the survey. The average overall score of 10 young people increased from 9.1% before and after the survey, and the scores ranged from “agree” to “strongly agree” (P= .001). After participation, each subset of questions significantly increased scores: knowledge, P= .002, confidence, P= .006, and comfort, P= .01. For the next phase of the scenario, caregivers needed an average of 20% speed. The children had 70% women, 80% Caucasians, and 60% state insurance, and the average age at the time of their tracheostomy was 4 months (range from 0 months to 24 years). Within 90 days of sending home, 3 children (n = 3/9) [33.3%]) were re-admitted for tracheitis. Participation increased the knowledge, confidence and comfort level of the caregivers. Because tracheostomy patients were medically vulnerable, caregivers should be aware and prepared for common tracheostomy crises and “manual” emergency scenarios.

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