How long do caregivers of children with tracheostomies retain life-saving skills after educational training with simulation?

Abstract

Background: Children with tracheostomies are an important subset of medically fragile children. Caregivers must act immediately if tracheostomy obstruction or decannulation occurs. The Canadian Thoracic Society recommends caregivers complete a formal education program. In the literature, simulation-based learning has improved emergency skills. A module and simulation-based training program for primary caregivers was developed. Objective: Assess effectiveness of new program and retention of caregiver knowledge and skills. Methods: A single-center prospective study to identify components of knowledge and skills retained at different intervals after training. All primary caregivers of children with tracheostomies born from 2007–2017 were invited to participate. Group I was trained using modules and simulation. Group II had been trained prior to the new program. Caregiver skills were evaluated with simulation to assess management of tracheostomy obstruction. Pre and post self-efficacy questionnaires were completed by caregivers. Results: Caregiver simulation evaluations were completed (n=9) including Group I (n=5) and Group II (n=4). Overall, 89% of tracheostomy changes were done in less than 2 minutes. 45% of caregivers scored higher on the self-efficacy survey after simulation. Group I caregivers scored higher on average than Group II, but numbers did not reach statistical significance. Conclusion: Simulation-based learning is effective for training caregivers of children with tracheostomies. This study will extend to other caregivers to improve the training program. Caregivers require ongoing education and simulation opportunities to manage tracheostomy emergencies safely.