Traditional Poster Round
Context: : Preparing families to safely transition home with a child on a ventilator, involves full partnership between the family and the medical care team. To better prepare our families for the challenges of caring for their infant with a tracheostomy at home, we developed a plan to provide parents opportunities to work in the clinical simulation laboratory. We created real life emergency scenarios, challenging parents to assess the patient’s condition and implement steps to resolve the situation.
Although, we had a discharge training plan for caregiver tracheostomy and ventilator care, we did not have a hands-on element for management of unexpected events. A literature review revealed that using simulation as an adjunct to traditional education, reinforces the knowledge and skills required for caring for a medically complex child. Simulation based education was developed using scenarios of varying acuity. Parents complete a survey prior to the training to establish a baseline of their confidence in different areas of tracheostomy and ventilator care. In the simulation lab families are challenged with assessment, troubleshooting equipment, emergency trach changes, and performing cardiorespiratory resuscitation. After each scenario, a debriefing session is held to review and reflect on the outcomes in order to improve future performance. At the conclusion, caregivers once again fill out the questionnaire updating their confidence levels in handling emergency medical situations.
The data results show an increase from moderately to extremely comfortable in nearly all categories of the questionnaire. Our work with families in the simulation laboratory has proven to be successful with a decrease in anxiety and an increase in confidence levels. One family in particular reported back that “our daughter would not be alive today if we did not do the simulation training”.
Description: : Simulation for patient and family education can easily be replicated in a high or low fidelity simulation situation. Understanding the learning style, educational level, and preferred language of the participants is key to a successful simulation. Our program begins with a basic skill and each scenario builds on each other so learners are able to critically understand the development of each simulation.
Observation/Evaluation: : Evaluation included a pre and post questionnaire as well as physical evaluation of skills during the simulation. If the skills and assessment were not appropriately performed the simulation scenario was repeated. Data from the questionnaires has shown that families have a false sense of confidence prior to going to the simulation lab.
Discussion: : The focus of the project was based on patient safety for the discharge of a tracheostomy and ventilated patient. All learners have returned to the hospital and have verbalized that the simulation training saved their child's life by teaching them how to appropriately respond in an emergency. Our program has been enhanced this year as we have moved into a brand new building with rooms dedicated to family simulation for a more realistic experience.