Authors (including presenting author) :
Tsoi SCT (2)(3), So HM (1)(2), Chau LTC (3), Leung YWN (1)(2), Hui TPB (3)
Affiliation :
(1) Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital (2) Nethersole Clinical Simulation Training Centre, Pamela Youde Nethersole Eastern Hospital (3) Nursing Services Division, Pamela Youde Nethersole Eastern Hospital
Introduction :
Tracheostomy emergency is uncommon but potentially life-threatening without prompt interventions. Simulation training is popular in medical education nowadays, allowing participants to handle critical situations and experience human factors affecting the performance from the experienced to novice. The training needs of nurses vary in experience levels and specialties working in, while simulation alone cannot accommodate the needs. Related training curriculum for tracheostomy management catering to the needs for all was limited.
Objectives :
To provide a sustainable multimodality training course to nurses of different levels in managing tracheostomy emergencies.
Methodology :
A three-pillars training model with tailored curriculum was designed for participants as follow:
Induction program for novice nurses:
A 100 minutes comprehensive tracheostomy training session focusing on practicing various tracheostomy nursing practices, identifying signs for tracheostomy emergencies by designed algorithms via short simulation scenarios.
Train-the-Trainer (TTT) program for department nurse trainers:
A 3.5 hours simulation training workshop focused on recognizing tracheostomy situations, tracheostomy care practices with detailed rationales discussed. Immersed high-fidelity scenarios followed by debriefing were experienced. Teaching tactics and training design were discussed. Trainers completed the courses were assigned to design and deliver tailor-made training in their respective departments.
Cluster simulation training to senior (experience >5 years)/ in-charge nurses:
A 3.5 hours simulation training workshop focused on managing tracheostomy emergencies in a multidisciplinary approach. Lecture highlights with emergency procedural skills practice (Assist bedside change of tracheostomy tube) and multidisciplinary simulation via immersed scenarios were included.
Kirkpatrick's principle of training evaluation was adopted. The post-workshop questionnaire with a Likert scale (1-6) was conducted to evaluate the effectiveness of the various training modules.
Result & Outcome :
Total 8 cluster induction program and 8 tracheostomy training sessions were delivered in the year 2018-2019. More than 200 novice nurses participated. Around 96% of participants agreed the training was useful (Mean 5.18). Four TTT workshops were conducted and 59 nurses were trained in the Year 2018. They were satisfied with the workshops (Mean 5.35) with significant improvement in assessment skills and competency (Mean 5.46). More than 10 departmental training within clusters were designed and organized by the trainer nurses in the year 2018-2019 with over 100 participants were trained. Four cluster simulation training workshops for senior/ in-charge nurses were held in the Year 2019, with 96 nurses and 5 doctors were trained. Their satisfaction toward multidisciplinary training between nurses (Mean 5.65) and doctors (Mean 5.25) was high. From April 2018 to December 2019, no tracheostomy-related incident within the cluster was reported in terms of the reportable sentinel events and serious untoward events.
