Tracheostomy (Warrenville, Ill.)最新文献

{"title":"Above Cuff Vocalization for Patients with Tracheostomy: An Evidence Informed, Interprofessional Practice Guidance (2026).","authors":"Vinciya Pandian, Therese K Cole, Kathryn Mattare, David J Feller-Kopman","doi":"10.62905/001c.158938","DOIUrl":"10.62905/001c.158938","url":null,"abstract":"<p><strong>Background: </strong>Loss of verbal communication following tracheostomy is associated with substantial patient distress, reduced quality of life, and impaired participation in care. Many patients with cuffed tracheostomy tubes are unable to tolerate cuff deflation or one-way speaking valves due to ventilatory dependence or airway instability, limiting access to traditional voicing strategies. Above cuff vocalization (ACV) enables phonation while the tracheostomy cuff remains inflated by delivering low-flow gas through a dedicated speech lumen. Despite increasing evidence supporting its feasibility and communication benefits, adoption of ACV remains inconsistent across institutions, partly due to safety concerns and the absence of standardized interprofessional practice guidance.</p><p><strong>Objective: </strong>To develop evidence-informed, implementation-focused interprofessional practice guidance to support the safe initiation, use, monitoring, and discontinuation of ACV in adults with tracheostomy.</p><p><strong>Methods: </strong>This practice guidance was developed using a structured narrative review of peer-reviewed literature addressing ACV mechanisms, feasibility, safety, communication outcomes, and implementation in acute and post-acute care settings, combined with interprofessional clinical expertise in tracheostomy care, speech-language pathology, respiratory therapy, nursing, and medicine. Development and reporting were informed by the Reporting Items for Practice Guidelines in Healthcare (RIGHT) statement. Formal evidence grading systems were not applied because the available literature consists primarily of observational and implementation studies; recommendations are therefore evidence-informed and consensus-supported.</p><p><strong>Recommendations: </strong>Key recommendations emphasize structured patient selection; interprofessional, speech-language pathology-led initiation; low-flow gas titration to the minimum effective level required for phonation; time-limited use with continuous clinical observation; and explicit safeguards to mitigate known risks, including air trapping, mucosal injury, and equipment misconnection. The guidance also outlines interprofessional roles, standardized procedures, monitoring requirements, documentation expectations, and escalation pathways to support safe implementation.</p><p><strong>Conclusions: </strong>This evidence-informed practice guidance translates the existing ACV literature into actionable clinical recommendations designed to support safe and consistent implementation across care settings. Adoption of standardized ACV practices may facilitate earlier restoration of speech, enhance patient communication and experience, and maintain airway safety in selected adults with cuffed tracheostomy tubes.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"3 1","pages":"42-48"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrahospital Transport of Adults with Tracheostomy, Laryngectomy, and other Surgical Airways: A Scoping Review of Risks, Processes, and Outcomes.","authors":"Naomi B Gizaw, Isabel A Snee, Naomi Ns Walter, DeMarcus M Burke, Jai'el R Toussaint, Raivat Shah, Youssef A Nagaty, Sarah E Hughes, Ferdie Z Galicia, Angela M Fetsko, Laura C Nairns, Linda M Williams, David Goldenberg, Michael J Brenner, Vinciya Pandian","doi":"10.62905/001c.155766","DOIUrl":"10.62905/001c.155766","url":null,"abstract":"<p><strong>Background: </strong>Transport of adults with tracheostomies, laryngectomies, or other surgical airways can cause airway compromise, physiologic instability, and preventable harm, yet transport practices remain inconsistent. This scoping review mapped evidence on intrahospital transport of adults with surgical airways, described transport processes and outcomes, and identified priorities for safer care.</p><p><strong>Methods: </strong>Following PRISMA guidance, we searched six databases through March 2024 for primary studies of adults undergoing intrahospital transport with surgical airways that reported adverse events, clinical outcomes, or resource use. Reviewers independently screened studies, extracted data, and assessed risk of bias for nonrandomized studies using ROBINS-I. Findings were synthesized narratively.</p><p><strong>Results: </strong>Of 1,118 records, six studies met inclusion criteria, including prospective cohorts, retrospective reviews, and one pre-post handoff intervention, with sample sizes from 48 to 521 patients. Cardiorespiratory alterations occurred in up to 67 percent of transports, and complications affected 28 percent of critically ill cancer transports. Compared with mechanically ventilated non-transported patients, transported patients had longer durations of ventilation, ICU stay, and hospital stay, and experienced higher ventilator-associated pneumonia and mortality rates. A structured operating room-to-ICU handoff reduced omitted information but did not change mortality or length of stay. Most studies had moderate risk of bias.</p><p><strong>Conclusions: </strong>Intrahospital transport of adults with surgical airways is associated with instability, complications, and increased resource use, yet evidence is limited and transport processes vary widely. Multicenter studies enrolling tracheostomy patients and testing standardized, airway-focused transport bundles and structured handoffs are needed to inform best practices and improve safety.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"3 1","pages":"30-41"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Equity in Tracheostomy Care with the Individuals with Disabilities Education Act.","authors":"Vinciya Pandian, Michael J Brenner","doi":"10.62905/001c.158807","DOIUrl":"10.62905/001c.158807","url":null,"abstract":"<p><p>The 50th anniversary of the Individuals with Disabilities Education Act (IDEA), enacted in 1975, offers an opportunity to consider its relevance in educational settings and healthcare delivery. Whereas medically complex children and adults historically had limited educational opportunity, there is growing momentum around developing inclusive learning environments. IDEA established durable principles centered on access, individualized support, and shared accountability across systems. These principles are highly relevant to the needs of individuals living with tracheostomies and their care partners, who often face ongoing challenges related to communication, mobility, medical complexity, and participation in daily life. High-quality tracheostomy care requires sustained patient and family engagement, coordinated interprofessional teams, and systems that recognize disability as a multidimensional experience rather than a single clinical condition. Building on IDEA's emphasis on individualized education plans, effective tracheostomy care requires personalized planning informed by patient and caregiver priorities and supported by appropriate accommodations across care settings. The mission of the Global Tracheostomy Collaborative reflects this shared focus on equity, access, and outcomes through collaborative, patient-centered models of care. This article examines IDEA's legacy as a conceptual framework for advancing tracheostomy care, addressing barriers and emerging solutions. Ongoing challenges include workforce limitations, fragmented care, and uneven access to resources. At the same time, developments in telemedicine, assistive communication technologies, data-driven quality improvement, and simulation-based training offer practical tools to improve coordination and inclusion. Viewed through the lens of IDEA's core principles, these approaches support more equitable and responsive lifelong learning for individuals with tracheostomy care across the lifespan.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"3 1","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lived Experience of Individuals with a Tracheostomy and their Caregivers: A Qualitative Analysis.","authors":"Michael J Brenner, Chandler H Moser, Erin Ward, Ethan D Sperry, Barbara Bosworth, Amy Freeman-Sanderson, Sarah Allgood, Vinciya Pandian","doi":"10.62905/001c.147784","DOIUrl":"10.62905/001c.147784","url":null,"abstract":"<p><strong>Objective: </strong>To explore the lived experiences of individuals with tracheostomies, their caregivers, and healthcare professionals to identify challenges and inform patient-centered care efforts.</p><p><strong>Study design: </strong>A qualitative survey with thematic analysis.</p><p><strong>Setting: </strong>Global Tracheostomy Collaborative learning community.</p><p><strong>Methods: </strong>Participants were recruited via a purposive online survey featuring open-ended questions designed to capture diverse stakeholder perspectives. A phenomenological approach within a constructivist-interpretivist paradigm guided the study, employing the International Classification of Functioning framework to examine biopsychosocial dimensions of tracheostomy care. Thematic analysis followed Braun and Clarke's six-phase methodology, with independent coding, iterative refinement, reflexive journaling, triangulation, and peer debriefing.</p><p><strong>Results: </strong>A total of 191 participants from 17 countries contributed to the study, revealing three overarching themes. (1) Tracheostomy as Lifeline and Vulnerability: Participants described tracheostomy as life-saving yet associated with social isolation, communication barriers, stigma, and supply shortages. (2) Dual-Sided Risk Perceptions: Individuals expressed fears about infection risks and stigma, while caregivers and healthcare professionals highlighted concerns about tracheostomy as a potential transmission risk. (3) Disrupted Care and Team Function: Challenges included limited multidisciplinary support, restricted access to critical supplies, and constrained care protocols, which affected patient and caregiver safety and well-being.</p><p><strong>Conclusion: </strong>Tracheostomy patients face compounded vulnerabilities, highlighting the need for holistic, patient-centered care models that address physical, social, and emotional challenges. Inclusive and adaptive healthcare practices are essential to mitigate risks, reduce stigma, and enhance the quality of life for individuals with a tracheostomy and caregivers, especially during healthcare crises.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"2 3","pages":"33-42"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Shared Vision for Tracheostomy Care: How the ICN's Updated Framework Strengthens Collaboration.","authors":"Vinciya Pandian, Michael J Brenner","doi":"10.62905/001c.147788","DOIUrl":"10.62905/001c.147788","url":null,"abstract":"<p><p>Tracheostomy care spans critical care, rehabilitation, and community settings, requiring collaboration among clinicians, patients, and families. The International Council of Nurses' (ICN) 2025 definitions of nursing and a nurse provide a timely framework for advancing this continuum, emphasizing equity, health literacy, cultural safety, and shared accountability. These principles align with the mission of the Global Tracheostomy Collaborative, which promotes interprofessional teamwork, caregiver engagement, and data-driven quality improvement. Within this model, nurses serve as system integrators, working with patients and professionals in safeguarding airway management, supporting transitions, and empowering families with knowledge and confidence. Evidence demonstrates that structured protocols, discharge planning, and caregiver training reduce complications, disparities, and readmissions. Globally, nurses are also critical team members who drive innovation in resource-limited settings, adapting protocols and educational strategies to community needs. By situating tracheostomy care within the ICN framework, we highlight the central role of nurses as autonomous practitioners and collaborative partners. Specific examples illustrate this continuum. The renewed definitions reinforce that tracheostomy safety and dignity depend not on isolated tasks, but on coordinated, culturally responsive systems of care. This shared language affirms recognition of contributions of all health professional engaged in interprofessional collaboration, thereby offering a global vision for safer, more equitable outcomes across the tracheostomy journey.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"2 3","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheostomy Care in the Crosshairs: Supporting Science and Safety Nets in Tumultuous Times.","authors":"Michael J Brenner, Vinciya Pandian","doi":"10.62905/001c.140856","DOIUrl":"https://doi.org/10.62905/001c.140856","url":null,"abstract":"<p><p>Individuals living with tracheostomies represent a medically complex population whose outcomes have measurably improved through innovations driven by academic medicine and publicly funded research. A growing body of high-quality evidence demonstrates that multidisciplinary tracheostomy teams, standardized care protocols, and interprofessional education can reduce complications, shorten hospital stays, enhance communication, and improve quality of life. However, the lifeline for innovation and care in communities is supported by public investment in federal research grants and programs like Medicaid, the principal insurer for many individuals requiring long-term tracheostomy care. Reducing this lifeline amplifies risks for children, adults, individuals with disabilities, particularly those in rural or socioeconomically disadvantaged communities. The prospect of stark reductions in NIH indirect cost funding and sweeping cuts to Medicaid jeopardize both the infrastructure of clinical research and the care pathways it has enabled. This editorial explores the rationale for preventing disinvestment, which not only endangers current standards of care but also undermines decades of investigative research that has tangibly advanced patient outcomes. Sustained progress depends on protecting the ecosystem that links federally funded science to equitable, high-quality care. In the face of growing policy headwinds, a renewed national commitment to evidence-based investment in research and coverage is the best hope for patients for whom innovation is essential.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"2 2","pages":"36-41"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12840448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just Culture in a Fragmented System: Ethical and Quality Imperatives in Cross-Institutional Tracheostomy Care.","authors":"Ruby J Kazemi, Isabel Snee, Nicholas R Lenze, Norman D Hogikyan, Vinciya Pandian, Michael J Brenner","doi":"10.62905/001c.141114","DOIUrl":"10.62905/001c.141114","url":null,"abstract":"<p><p>Although the ethical imperative to respond to medical errors that cause patient harm is well established, reporting errors that span institutional boundaries introduces added ethical, professional, and practical challenges. This article examines these tensions through the fictitious case of a patient who had repeated tracheostomy dislodgement, highlighting the responsibilities of healthcare professionals to maintain transparency, foster trust, and promote systemic quality improvement. While disclosing errors to patients and families is widely recognized as essential to ethical and patient-centered care, reporting mistakes made by colleagues, especially across healthcare systems, raises issues of professional responsibility, institutional accountability, and medicolegal risk. Healthcare professionals must navigate considerations of individual accountability versus systemic failure to support a culture of learning. In high-risk settings such as tracheostomy care, adverse events often arise from both human error and systemic deficiencies, underscoring the need for structured reporting mechanisms that support ethical disclosure, interprofessional communication, and data-driven quality improvement. This discussion highlights the evolving expectations for professional self-regulation, the role of structured feedback in improving care, and the ethical imperative to protect future patients while maintaining fairness to colleagues. Advancing patient safety is thus predicated on strengthening institutional policies and fostering a culture of accountability without instilling fear or inappropriately attributing blame. A just culture approach, emphasizing learning, transparency, and systemic improvement, provides a pathway to reconciling ethical obligations with practical solutions, ensuring the highest standards of care.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"2 2","pages":"30-35"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheostomy in the Digital Age: How Artificial Intelligence and Immersive Technologies Are Redefining Airway Care.","authors":"Vinciya Pandian, Michael Brenner","doi":"10.62905/001c.133583","DOIUrl":"10.62905/001c.133583","url":null,"abstract":"<p><p>Tracheostomy care is a critical aspect of airway management, yet persistent gaps in provider training, patient education, and healthcare accessibility contribute to inconsistent clinical outcomes. Innovative technologies offer the promise of accelerated learning and scalable interventions. Artificial intelligence (AI), simulation, and digital health solutions have transformative potential for bridging these deficiencies. This article explores the integration of AI-driven technologies in tracheostomy education, workforce development, telehealth, predictive analytics, and robotic-assisted airway management. AI-powered learning platforms, including virtual reality simulations and conversational AI, enhance skill acquisition and clinical confidence, addressing significant competency deficits. Telehealth solutions, augmented by AI-driven monitoring and decision-support systems, can improve follow-up care, reduce hospitalizations, and expand patient access to expert consultation. Additionally, predictive analytics and machine learning models can optimize tracheostomy placement, complication prevention, and long-term patient outcomes, while robotic-assisted airway interventions demonstrate potential for enhanced procedural precision. Despite these advancements, challenges such as algorithm transparency, content readability, and human oversight must be addressed to maximize AI's effectiveness. As AI continues to evolve, future research should focus on refining these technologies, ensuring ethical implementation, and integrating AI solutions into standardized clinical workflows to enhance patient safety and healthcare efficiency.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"2 1","pages":"5-14"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Education and Care Gaps in Tracheostomy Management: Insights from a Multi-Stakeholder Global Survey.","authors":"Michael J Brenner, Smita Sahay, Rachael M Silveira, Chandler Moser, Michelle E Morrison, Nicole K Zeitler, Christina J Yang, Maria Colandrea, Kylie McElroy, Vinciya Pandian","doi":"10.62905/001c.129226","DOIUrl":"https://doi.org/10.62905/001c.129226","url":null,"abstract":"<p><strong>Objective: </strong>To identify gaps in tracheostomy care related to education, workforce competency, access, affordability, and caregiver empowerment, and to provide actionable insights for improving global tracheostomy practices.</p><p><strong>Design: </strong>Cross-sectional, descriptive study utilizing a global multi-stakeholder survey.</p><p><strong>Methods: </strong>A 19-item survey, developed collaboratively with healthcare professionals (HCPs), patients, and caregivers, was distributed to members of the Global Tracheostomy Collaborative. Respondents rated tracheostomy care challenges on a severity scale and provided qualitative insights. Quantitative data were analyzed descriptively, while qualitative data were stratified by stakeholder group and thematically synthesized.</p><p><strong>Results: </strong>A total of 170 respondents from 14 countries and diverse professional roles, including speech-language pathologists (30%), nurses (24%), and respiratory care practitioners (24%), identified major challenges. The most critical issues included limited availability of HCPs with tracheostomy expertise (median severity score: 8), inequities in access to care (7), and affordability concerns (6). Key themes included inadequate education and training, inconsistent suctioning and stoma care techniques, and insufficient caregiver empowerment. Barriers specific to underserved populations and resource-limited settings included geographic access limitations, financial strain, and workforce shortages. Respondents emphasized the need for standardized training, simulation-based education, telehealth solutions, and equitable resource allocation to improve care delivery.</p><p><strong>Conclusion: </strong>This study highlights significant challenges in global tracheostomy care and emphasizes the need for targeted interventions, such as innovative training frameworks, standardized care pathways, and policy-level changes to address systemic inequities. Enhanced interdisciplinary collaboration and patient-centered approaches are critical for improving outcomes and reducing caregiver burden. Future efforts must prioritize scalable solutions to bridge gaps in underserved and resource-constrained settings.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"2 1","pages":"15-28"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12841422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of AvTrach^® Wearable Airway Simulator versus High-Fidelity Manikin on Tracheostomy Suctioning Competency and Physiological Stress: A Multi-Institutional Randomized Controlled Trial.","authors":"Vinciya Pandian, Maria Colandrea, Nancy Sullivan, Carol S Maragos, Stanola Stanley, Michael J Brenner","doi":"10.62905/001c.132160","DOIUrl":"10.62905/001c.132160","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effectiveness of AvTrach^® wearable artificial airway simulators (AWAS) compared to high-fidelity manikins (HFM) in enhancing tracheostomy suctioning competency, managing physiological stress, and improving engagement through dimensions of physical, conceptual, and psychological fidelity.</p><p><strong>Design: </strong>A multi-institutional, randomized controlled trial (RCT) was conducted to compare AWAS with HFM training modalities for tracheostomy suctioning among healthcare professionals and students.</p><p><strong>Methods: </strong>Participants (n = 69) from two institutions were randomized into experimental (AWAS) and control (HFM) groups. Competency was assessed using an Objective Structured Clinical Examination tool, and stress responses were measured through salivary cortisol levels. The study encompassed four sessions: recruitment, baseline competency levels and training, simulation, and clinical demonstrations. Quantitative data were analyzed using descriptive statistics, Wilcoxon rank-sum tests, and mixed-effects regression models.</p><p><strong>Results: </strong>Both groups demonstrated improved competency post-training (p < 0.001). However, the AWAS group achieved higher clinical competency scores (p < 0.001) and exhibited stable cortisol levels during clinical demonstrations, indicating better stress adaptation. Participants in the AWAS group also reported higher engagement, attributed to dynamic feedback and enhanced emotional immersion.</p><p><strong>Conclusion: </strong>AWAS training, integrating physical, conceptual, and psychological fidelity, significantly enhances tracheostomy care competency and stress management compared to HFM. This approach supports technical skill development, emotional preparedness, and interprofessional collaboration, essential for high-stakes clinical environments.</p>","PeriodicalId":520079,"journal":{"name":"Tracheostomy (Warrenville, Ill.)","volume":"2 1","pages":"43-55"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}