Department of Pediatrics, Weill Cornell Medicine and
John Hopkins All Children's Hospital, St Petersburg, Florida.
Hosp Pediatr. 2021 Jun;11(6):571-578. doi: 10.1542/hpeds.2020-000984. Epub 2021 May 12.
To design, implement, and evaluate a simulation-based education (SBE) program for caregivers of children with tracheostomy.
Self-reported comfort and confidence in knowledge as well as tracheostomy care skills were assessed before and after a single SBE session for 24 consecutively enrolled caregivers of children with tracheostomies aged <21 years who were hospitalized at an academic medical center from August 2018 to September 2019 by using a survey and checklist, respectively. Mean individual and aggregated scores were compared by using a paired samples t-test, and association between instruments was determined with Spearman correlation.
Post-SBE, there was a significant improvement in both self-reported comfort and confidence ( < .001) and checklist assessment of most tracheostomy care skills ( < .001). There were no significant correlations between caregivers' self-reported comfort and confidence and skills pre-SBE (ρ = 0.13) or post-SBE (ρ = 0.14). Cronbach's α coefficients for the survey ranged from 0.93 to 0.95 and for the checklist from 0.58 to 0.67. Seventeen percent of caregivers competently completed the entire checklist post-SBE, with most caregivers missing 1 or 2 critical skills such as obturator removal after tracheostomy insertion.
In this pilot study, we demonstrated successful design and implementation of an SBE program for caregivers of children with tracheostomies, revealing improvements in self-reported comfort and confidence as well as in their performance of tracheostomy care skills. Further optimization is needed, and caregivers may benefit from additional SBE sessions to achieve complete skills competency. Future research on the long-term impact of SBE and the peer-to-peer support element of the program is needed.
为气管切开患儿的照料者设计、实施并评估一项基于模拟的教育（SBE）项目。
对 2018 年 8 月至 2019 年 9 月在学术医疗中心住院的 24 名连续入组的、年龄<21 岁的气管切开患儿的照料者，在参加单次 SBE 课程前后，分别通过问卷调查和检查表评估其对自身舒适度和知识信心的自我报告，以及对气管切开护理技能的自我报告。采用配对样本 t 检验比较个人和综合评分的均值，并用 Spearman 相关分析确定两种工具之间的相关性。
SBE 后，自我报告的舒适度和信心（<0.001）以及大多数气管切开护理技能的检查表评估（<0.001）均显著改善。SBE 前，照料者自我报告的舒适度和信心与技能之间没有显著相关性（ρ=0.13）；SBE 后也无显著相关性（ρ=0.14）。问卷调查的 Cronbach's α 系数范围为 0.93 至 0.95，检查表的 Cronbach's α 系数范围为 0.58 至 0.67。SBE 后，17%的照料者能够完全完成整个检查表，大多数照料者缺少 1 至 2 项关键技能，例如气管切开插入后拔出堵塞器。
在这项试点研究中，我们成功地为气管切开患儿的照料者设计并实施了一项 SBE 项目，表明他们的自我报告舒适度和信心以及气管切开护理技能都得到了提高。还需要进一步优化，而且照料者可能受益于额外的 SBE 课程，以实现完全的技能熟练程度。需要进一步研究 SBE 的长期影响以及该项目的同伴支持要素。
