Authors (including presenting author) :
TSANG WL(1), LIM JJM(1), NG WF(1), LAU SY(1), WONG KY(1)
Affiliation :
(1)Department of Surgery, United Christian Hospital
Introduction :
Tracheotomy complications can be life-threatening. Mitigating these risks through effective education is crucial. This study introduces a quality improvement initiative integrating high-fidelity simulation (HFS) training to deliver practical on-the-job (OTJ) learning experiences.
Objectives :
To enhance confidence and competence of healthcare workers in managing (i) displacement of a tracheostomy tube with adjustable neck flange in a patient with tracheal deviations due to thyroid carcinoma and (ii) bleeding from a mature tracheostomy.
Methodology :
A pre-test/post-test quasi-experimental design was employed, featuring a one-hour high-fidelity simulation training. This training engaged 33 healthcare providers and students from Departments of Surgery, Medicine & Geriatrics, and Family Medicine & Primary Healthcare.
The scenarios were designed in adherence to INACSL Healthcare Simulation Standards of Best Practice and NLN/Jeffries Simulation Theory. The training emphasized psychological safety and learning outcomes of participants, guided by The Basic Assumption from the US Center for Medical Simulation.
Participants' knowledge and confidence in managing tracheostomy emergencies were assessed using the C-Scale, under the permission of overseas nursing scholar Professor Susan E. Grundy.
Result & Outcome :
33 healthcare professionals and students engaged in the simulation workshop, with varying levels of clinical experience.
The Wilcoxon Signed-Rank test revealed a significant difference in C-scale indicating their confidence regarding tracheostomy emergency management pre- and post-HFS training (z=-4.555, p< .001). The participants exhibited notable progress, with the median C-scale increasing from 11/25 pre-HFS to 18/25 post-HFS. This improvement underscores its efficacy in enhancing confidence of participants. The training also led to a significant enhancement in tracheostomy-related knowledge, with a median score increase from 4/14 pre-HFS to 8/14 post-HFS (z=-4.649, p< .001). This improvement showcases its effectiveness in enhancing both practical skills and theoretical understanding among participants.
Furthermore, the simulation training program demonstrated cost-effectiveness, offering a pragmatic and resource-efficient approach to skill enhancement. Through the provision of high-fidelity scenarios and secure hands-on practice within a controlled setting, the HFS training reduces the necessity for costly real-life training situations. This results in superior learning outcomes without the burden of excessive visible and hidden expenses that may arise from actual incidents.
Feedback from participants indicated a high level of satisfaction, with all rating the training 5/5 for usefulness. Qualitative feedback highlighted the value of HFS in acquiring knowledge and skills, underlining the effectiveness and relevance of this simulation-based training program.
