Impact of emergency management in a simulated home environment for caregivers of children who are tracheostomy dependent

IF 1.2 4区医学 Q3 NURSING

Journal for Specialists in Pediatric Nursing Pub Date : 2021-12-19 DOI:10.1111/jspn.12366

Malorie Brooks MSN, RN, CPN, CHSE, Linda Jacobs MPH, RRT-NPS, CHSE, Mary Cazzell PhD, RN

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引用次数: 3

Abstract

Purpose

Children who are tracheostomy dependent require comprehensive caregiver preparation for safe hospital-to-home transition. Although a structured discharge education program successfully trained caregivers to provide routine daily tracheostomy care, emergency response training was limited, lacking realistic experiences. Initiation of simulated emergency training for caregivers indicated performance confusion related to tracheostomy cardiopulmonary resuscitation (CPR). This study evaluated the effectiveness of an evidence-based tracheostomy CPR education intervention via caregiver participation in a high-fidelity simulation of a home-based emergency scenario on the performance of essential behaviors, comfort, and satisfaction.

Design and Methods

The study utilized a prospective descriptive pre- and post interventional design; 44 caregivers of children who were tracheostomy dependent participated. All caregiver participants completed: video- and instructor-assisted specialized tracheostomy CPR class, high-fidelity simulation performance of a home-based emergency (respiratory failure with cardiac arrest), postsimulation video debriefing, performance assessment with an objective scoring rubric, and pre- and post simulation surveys on levels of comfort and satisfaction.

Results

On the performance of essential emergency management behaviors, 86.4% of caregivers performed all four behaviors, but only 36.4% performed these essential behaviors in order. Post simulation caregiver comfort with emergency management significantly increased from pre simulation (p = .001). All caregivers were satisfied with this training and would recommend simulation of home-based emergencies for all caregivers. Qualitative feedback from caregivers revealed themes of gratitude and the importance of hands-on practice with guided debriefing/feedback. Study power was 0.98.

Practice Implications

Objective evaluation of caregiver performance demonstrated specialized tracheostomy CPR education prepared caregivers to respond in a home emergency. Caregivers viewed simulation as an opportunity to gain hands-on experience and improve emergency responses. It may be beneficial for other similar programs to include specialized tracheostomy CPR and emergency scenario simulation in their discharge education protocols and subsequently compare this program to other similar programs to establish best practice guidelines.

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模拟家庭环境中的应急管理对依赖气管切开术儿童护理人员的影响

目的依赖气管切开术的儿童需要全面的护理人员准备，以实现从医院到家庭的安全过渡。尽管一个结构化的出院教育项目成功地培训了护理人员提供日常气管切开术护理，但应急响应培训有限，缺乏实际经验。对护理人员进行模拟紧急训练表明，与气管切开术和心肺复苏(CPR)相关的表现混乱。本研究评估了基于证据的气管切开术CPR教育干预的有效性，通过护理人员参与高保真模拟基于家庭的紧急情况，对基本行为、舒适度和满意度的表现进行了评估。设计与方法本研究采用前瞻性描述性介入前后设计;44名依赖气管切开术儿童的护理人员参与了研究。所有的护理人员参与者都完成了:视频和指导员辅助的专门气管切开术CPR课程，基于家庭的紧急情况(呼吸衰竭伴心脏骤停)的高保真模拟表现，模拟后的视频报告，客观评分标准的表现评估，以及模拟前和模拟后的舒适度和满意度调查。结果在急救基本管理行为的执行上，86.4%的护理人员全部执行了四种基本管理行为，但只有36.4%的护理人员依次执行了四种基本管理行为。与模拟前相比，模拟后护理人员对应急管理的满意度显著提高(p = .001)。所有护理人员都对这次培训感到满意，并建议所有护理人员模拟家庭紧急情况。来自护理人员的定性反馈揭示了感恩的主题以及指导汇报/反馈的实践实践的重要性。研究能力为0.98。实践意义对护理人员表现的客观评价证明了专门的气管切开术心肺复苏术教育使护理人员能够应对家庭紧急情况。护理人员将模拟视为获得实践经验和改善应急反应的机会。其他类似项目在其出院教育方案中加入专门的气管切开术、心肺复苏术和紧急情况模拟可能是有益的，并随后将该项目与其他类似项目进行比较，以建立最佳实践指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal for Specialists in Pediatric Nursing 医学-护理

CiteScore

2.50

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： Linking science and practice by publishing evidence-based information on pediatric nursing and answering the question, ''How might this information affect nursing practice?'' The Journal for Specialists in Pediatric Nursing (JSPN) is the international evidence-based practice journal for nurses who specialize in the care of children and families. JSPN bridges the gap between research and practice by publishing peer-reviewed reliable, clinically relevant, and readily applicable evidence. The journal integrates the best evidence with pediatric nurses'' passion for achieving the best outcomes. The journal values interdisciplinary perspectives and publishes a wide variety of peer-reviewed papers on clinically relevant topics.