Risk Management and Healthcare Policy (Sep 2022)
Assessment of Nurses’ Knowledge and Confidence Regarding Tracheostomy Care in a Pediatric Long Term Care Hospital in Saudi Arabia
Abstract
Rafat Mosalli,1,2 Gamal A Aboumoustafa,1 Wed Khayyat,3 Aziza N Bokhari,3 Mohammed A Almatrafi,2 Mohammed Ghazi,1,4 Bosco Paes5 1Department of Pediatrics, International Extended Care Center, Jeddah, Saudi Arabia; 2Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia; 3Medical College, Umm Al-Qura University, Makkah, Saudi Arabia; 4Department of Pediatrics, Division of Critical Care, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Pediatrics (Neonatal Division), McMaster University, Hamilton, Ontario, CanadaCorrespondence: Rafat Mosalli, Department of Pediatrics, Umm Al-Qura University, P.O. Box 7607, Makkah, Saudi Arabia, Tel +966 561182222, Fax +966 252-70000 Ext 4110, Email [email protected]: The incidence of tracheostomy insertion in pediatric patients has increased over the last few decades. Tracheostomized pediatric patients need daily, meticulous care by qualified nurses to minimize severe, avoidable complications. Adequately trained nurses facilitate patients’ stability, accelerate weaning from the ventilator, and reduce potential tracheostomy dislodgement.Methods: A cross-sectional, retrospective cohort survey was conducted in September 2021, using an electronic version of a self-questionnaire, to assess nurses’ knowledge and comfort level regarding tracheostomy care of pediatric patients at the International Extended Care Center in Jeddah, Saudi Arabia. Statistical analysis of the accrued data was performed using the SPSS 21.0 software package and a P-value < 0.05 calculated by t-Test, was considered significant.Results: Among 43 nurses included in the study, 14 (32.6%) were very comfortable taking care of tracheostomized patients, 13 (30.2%) were comfortable, and 16 (37.2%) were uncomfortable. Regarding knowledge, three main aspects of tracheostomy care were correctly answered (%) by all the nurses: knowledge of routine tracheal care (55%), tracheal care skills (11.6%), and tracheal emergency care (2.3%). The study showed a significant positive correlation between nurses’ comfort level with tracheal care and academic degree, duration of pediatric experience, completion of more than one life support course, and attendance at the annual local tracheostomy care competency learning program (TCCLP; all P < 0.05).Conclusion: Deficits exist in nurses’ knowledge of tracheostomy care. Improved knowledge garnered through repetitive participation in tracheostomy competency programs and life support courses correlate with greater comfort and more than 5 years of pediatric experience. Nurses’ deficits in emergency care knowledge and skills should be addressed through a structured educational program and a simulation, hands-on based TCCLP course, irrespective of comfort level with tracheostomy care.Keywords: pediatric nurses, tracheostomy, training skills, children, extended care, Jeddah