Traditional Poster Round
Background: : Despite difficulties, hospitals in resource-limited settings still perform complex procedures such as tracheostomies. The University Central Hospital of Kigali Rwanda performs around 50 tracheostomies each year, 20% of which are in children. Patient outcomes are hindered by inadequate post-operative care. Families receive basic tracheostomy training prior to discharge, yet are not sent home without education materials, suction machines, or basic necessary supplies. While there are a number of studies that have combated this issue in resource limited settings like Rwanda (1,2), few studies have attempted to pilot the implementation of tailored educational material in a simulated training course for nurses and residents in resource limited settings. Simulation, as an avenue of teaching, can be used not only to increase participants acquisition of technical skills, but to foster a more hands-on learning environment (3).
Research Question: : The pilot study aimed to implement a recently published educational image-based tracheostomy pamphlet, manual suctioning device and low-cost ambulatory supply kit (“Go Bags”), within a low-fidelity simulated training course in a resource limited setting.
Methodology: : The prospective observational pilot study consisted of 10 participants including otolaryngology residents and nursing staff from departments such as Otolaryngology, ICU, PICU, Pediatrics, and Neurology. The participants completed self-efficacy questionnaires before and after the training course as well as a post educational module survey. Outcomes measured include pre and post course questionnaires, post educational module evaluation, and observational data.
Results: : 10 participants (8 nurses and 2 residents) completed the training course. Before the training course, the participants’ confidence levels on a ten-point Likert scale in performing daily tracheostomy suctioning, tracheostomy tie change, tube change, guiding caregivers through educational material and potential emergency situations were as follows (median (Q1, Q3)): 8 (7, 9.75), 8 (5.25, 9), 5 (0.25, 6.75), 7 (3.25, 7.75), 6.5 (5.25, 9). After completing the course, their level of confidence improved substantially to 10 (10, 10), 10 (10, 10), 9 (8, 10), 10 (9, 10), 10 (9, 10). For the post-course educational material evaluation, participants reported the usefulness of the image-based tracheostomy pamphlet, ambulatory supply kit, and manual suctioning device on a ten-point Likert scale as follows (mean): 9.5, 9.6, 9.6.
Discussion/Conclusions: : There is a need for improving tracheostomy education among nursing and resident staff in resource limited settings. Implementing tailored educational material into a low-fidelity simulated tracheostomy care course was effective in improving technical skills and confidence.