Acorda Darlene E, Van Orne Julie
Department of Undergraduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Texas Children's Hospital, Houston, Texas, USA.
Otolaryngol Head Neck Surg. 2025 Jan;172(1):283-291. doi: 10.1002/ohn.1020. Epub 2024 Oct 15.
Safe discharge for children with tracheostomies requires caregivers to be competent in tracheostomy management, including emergency interventions. Inpatient pediatric units are tasked with preparing families for discharge, yet variations exist in the standards of tracheostomy education across institutions. To address this gap, we aimed to describe the inpatient tracheostomy education programs in children's hospitals across the United States.
This is a cross-sectional study conducted between May and July 2022.
We distributed an online survey to a purposeful sample of representatives from participating children's hospitals.
The 42-item survey evaluated various aspects of tracheostomy education, including teaching strategies, timing of education, operational support, and overall program structure. Descriptive statistics were generated, and researchers reviewed open-ended items to identify themes.
Thirty-seven institutions participated, 26 of which were free-standing children's hospitals. All programs surveyed conducted bedside checkoffs, required a rooming-in period, and provided tracheostomy cardiopulmonary resuscitation and low-fidelity simulation for emergency teaching. Programs varied in the order of education and the type of support received. Many programs lacked a postdischarge follow-up structure and the majority evaluated program effectiveness with readmission rates. Lack of private-duty nursing was the primary barrier to discharge, followed by family availability and reluctance to participate in education.
The program structure and support variations suggest that more investigation is needed in discharge education and postdischarge follow-up for children with tracheostomies. A national guideline for tracheostomy education and identification of standardized quality metrics for program evaluation would benefit current and emerging programs.
气管造口术患儿的安全出院要求护理人员具备气管造口术管理能力，包括紧急干预措施。儿科住院病房负责帮助家庭为出院做准备，但各机构气管造口术教育标准存在差异。为填补这一空白，我们旨在描述美国各地儿童医院的住院气管造口术教育项目。
这是一项于2022年5月至7月进行的横断面研究。
我们向参与研究的儿童医院的代表有目的地抽取样本，发放了一份在线调查问卷。
这份包含42个条目的调查问卷评估了气管造口术教育的各个方面，包括教学策略、教育时机、操作支持和整体项目结构。生成了描述性统计数据，研究人员审查了开放式问题以确定主题。
37家机构参与了研究，其中26家是独立儿童医院。所有接受调查的项目都进行了床边技能考核，要求有陪住期，并提供气管造口术心肺复苏和用于紧急教学的低保真模拟。各项目在教育顺序和获得的支持类型方面存在差异。许多项目缺乏出院后随访结构，大多数项目用再入院率来评估项目效果。缺乏私人护理是出院的主要障碍，其次是家庭是否有空以及不愿参与教育。
项目结构和支持方面的差异表明，对于气管造口术患儿的出院教育和出院后随访，需要进行更多研究。制定气管造口术教育的国家指南并确定用于项目评估的标准化质量指标，将使现有和新出现的项目受益。
