Authors (including presenting author) :
So HM (1)(2), Tsoi SC (2)(3), Leung YW (1)(2), Chau LTC (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 Department, Pamela Youde Nethersole Eastern Hospital
Introduction :
Tracheostomy emergencies happen from time to time. Nurses being the first responders are vital to initiate timely and appropriate emergency nursing care to ensure safe tracheostomy care. The primary invention of this 3Es home-made tracheostomy model has been used since 2015 for training of ICU nurses. Later the extensive application of this model is further enhanced especially for training of new nurse graduates. Mastering airflow mechanism in trachea and its association with the cuff status of tracheostomy tube can help new nurse graduates to differentiate different types of tracheostomy emergencies and their prompt management. However, the commercial manikins being expensive (USD$ 600-2500) with considerable weight and size cannot achieve these purposes due to lacking of visibility and flexibility. In view of these limitations, our simulation team based on the 3 Es (Efficient, Economic and Effective) principles to produce the tailor-made tracheostomy demonstration models to speed up nurses’ learning and teaching experience.
Objectives :
1. To facilitate nurse graduates to have better understanding of different types of tracheostomy care 2. To support nurse facilitators to have effective delivery of different types of tracheostomy care
Methodology :
The design of the innovative tracheostomy demonstration model is simple. It is made of clinically available materials including one-liter plastic bottle, plastic tubing, tracheostomy tube and artificial mouth. Different models were made to meet demonstration needs. Its transparency allows clear demonstration of the only airflow through permanent tracheostoma, direct vision of temporary tracheostomy with different types of tracheostomy tube, direct vision of no airflow to trachea in case of tube displacement. It also allows individual practice of skill on general tracheostomy care. Evaluation of these models were collected from nurse participants after their use of these models during the four tracheostomy care training sessions in 4Q 2019. The questionnaire included four questions focusing on visibility, clarity, user-friendly and usefulness of these innovative models with 6-points Likert scale. Participants were then asked to rate their overall satisfaction and acceptance towards these innovative models.
Result & Outcome :
Results Each model is light and can be produced within 20 minutes (Efficient) at a very low cost of HK$ 150 (USD $20) (Economic). Therefore, 20 handy demonstration models were prepared within one day to support demonstration and individual hand-on skill practice. A total of 105 returns were collected from nurse graduates (91) and nurse facilitators (14) respectively. All gave high score to the 4 questions with their means over 5 out of 6. The satisfaction towards these models were also rated high at very good or excellent (Effective) by most of the nurse graduates (93%, 85/91) and nurse facilitators (72%, 10/14) respectively. Conclusion These transparent, handy and user-friendly innovative tailor-made tracheostomy demonstration models are proved to be well accepted by healthcare professionals as a 3 Es cost-effective teaching aids to facilitate nurses’ learning and teaching experience for delivery of safe tracheostomy care.
