Mary Ellen Fain, Brittany A Truitt, Caroline C Ivie, Andrew Jergel, Rebecca L McCoy, Heather Brandt, Walter Reeder, Scott Gillespie, Dawn M Simon, Ajay S Kasi, Kara K Prickett
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引用次数: 0
Abstract
Objective: Tracheostomy-related emergencies (TRE) such as decannulation, cannula obstruction, and hemorrhage contribute significantly to mortality, emergency department (ED) visits, and hospitalizations. High-fidelity simulation-based training (SBT) for family caregivers can improve their competence in TRE management. The aims of the study were to compare the frequency of ED visits, readmissions, and mortality in children with tracheostomy based on caregiver completion of SBT.
Methods: Children who underwent tracheostomy from 2014 to 2020 were studied, with cohorts based on caregiver completion of SBT. Patients were followed for 1 year following hospital discharge after tracheostomy. The frequency and reasons for ED visits, readmissions, and mortality were evaluated.
Results: Among the 158 patients who met inclusion criteria, the caregivers of 83 (53%) patients completed SBT. Overall mortality was significantly lower (P < .001) among patients whose caregivers completed SBT (2%) compared to patients whose caregivers did not complete SBT (17%). There was no significant difference in mortality due to tracheostomy-related causes based on caregiver completion of SBT (P > .99). There were no significant differences in the total ED visits (P = .44) and readmissions (P = .11), or tracheostomy-related ED visits (P = .61) and readmissions (P = .45) based on caregiver completion of SBT.
Conclusion: Overall mortality was significantly lower among patients whose caregivers completed SBT. The frequency of ED visits, readmissions, and mortality due to tracheostomy-related causes did not differ between the groups. Although high-fidelity SBT may augment caregiver competence in TRE management, further study is needed to determine if SBT can measurably impact tracheostomy-related outcomes.
期刊介绍：
Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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