Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario.
University of Toronto, Toronto, Ontario.
Pediatr Pulmonol. 2017 Dec;52(12):1610-1615. doi: 10.1002/ppul.23842. Epub 2017 Oct 6.
Caregivers of children using home mechanical ventilation (HMV) via tracheostomy require appropriate knowledge and skills. Existing training curricula are locally developed and content variable. We sought to develop a competency checklist to inform initial training and subsequent assessment of knowledge and skills of family caregivers.
We used a 2-step process. Candidate items were generated by synthesis of a scoping review, existing checklists, with additional items suggested by an eight member inter-professional group representing pediatric HMV programs across Canada. Following removal of duplicate items, we conducted a three-round Delphi to gain consensus on items for the KidsVent Checklist.
The scoping review and checklists from five HMV programs identified 18 domains and 172 items; one additional domain and 83 additional items were identified by our expert group who also classified domains as mandatory or optional. We recruited 95 clinicians representing 12 Canadian paediatric HMV programs to participate in Delphi round 1 (response rate 72%; 84%, and 100% for subsequent rounds). Importance rating of the 255 items reduced them to 246 items. In the final checklist, the 19 domains comprised 14 mandatory (189 mandatory items) and 5 optional domains (57 optional items).
We have developed the KidsVent checklist using rigorous consensus building methods, informed by participants with diverse geographic and inter-professional representation. This checklist represents knowledge and skills required to safely care for children using tracheostomy ventilation at home. Further study is required to explore the impact of this checklist on outcomes of this growing group of technology-dependent children.
使用经气管造口术的家庭机械通气（HMV）的儿童的照料者需要适当的知识和技能。现有的培训课程是在当地开发的，内容各不相同。我们旨在制定一份能力检查表，为家庭照料者的初始培训和随后的知识和技能评估提供信息。
我们使用了两步法。候选项目是通过综合范围审查、现有检查表以及代表加拿大各地儿科 HMV 计划的八名跨专业小组成员提出的其他项目生成的。在删除重复项目后，我们进行了三轮 Delphi 研究，以就 KidsVent 检查表的项目达成共识。
范围审查和来自五个 HMV 计划的检查表确定了 18 个领域和 172 个项目；我们的专家组还确定了一个额外的领域和 83 个额外的项目，他们还将领域分类为强制性或可选性。我们招募了 95 名代表 12 个加拿大儿科 HMV 计划的临床医生参加 Delphi 第 1 轮（响应率为 72%；随后的两轮分别为 84%和 100%）。对 255 个项目的重要性评分将其减少到 246 个。在最终检查表中，19 个领域包括 14 个强制性（189 个强制性项目）和 5 个可选领域（57 个可选项目）。
我们使用严格的共识建立方法制定了 KidsVent 检查表，该方法由具有不同地理和跨专业代表性的参与者提供信息。该检查表代表了在家中使用气管造口术通气安全照顾儿童所需的知识和技能。需要进一步研究来探讨该检查表对这一不断增长的依赖技术的儿童群体的结果的影响。
