Authors (including presenting author) :
LAI YM, LAM YFF, LEE YCA, NG YS
Affiliation :
(1)ENT Department, Tung Wah Hospital
Introduction :
A tracheostomy is a surgical opening made into the trachea through the skin at the front of the neck, where an indwelling tube is placed to create an artificial airway. This procedure is for clients may needing long-term or permanent airway support. Some clients need to learn how to live with a tracheostomy. TWH ENT SOPD has a nurse-led clinic that mainly focus on providing inpatient and outpatient nursing consultation, education and teaching sessions about tracheostomy care to tracheostomized and end tracheostomy patients. The service includes wound care, changing and cleansing tracheostomy inner tube, changing tracheostomy tie and consumables information. We found that patients are insufficient, especially under COVID-19 pandemic, patient cannot attend for follow up or reassessment. For service enhancement, we provided telehealth support after completed the on-site training session.
Objectives :
Caregiver knowledge, satisfaction, self-efficacy, return demonstration and competence in tracheostomy skills increased after protocol implementation. Outcomes included no tracheostomy-associated complications, prevent unnecessary hospitalizations.
Methodology :
Case referred by doctor with discharge plan. Nurse clinic face-to-face appointment would be given. Patients and their caregiver would attend the appointment onsite, where education and demonstration on tracheostomy care, including dressing, changing inner tube, cleansing the tube and consumables, would be given. They would be required to perform return demonstrations afterward. After two basic on site sessions, completed reassessment of tracheostomy care. We will offer and consent the telehealth service to clients, during online sessions, re-education and reinforcement on tracheostomy care would be given with video and PowerPoint for easy understanding. Also, return demonstration of tracheostomy care is required in their home setting. Individualized advice would be given according to their needs. Further on-site or online follow-up would be arranged as needed. Normally, case will be closed when clients who have competent skills and without further enquiries.
Result & Outcome :
1. To provide comprehensive and continuum of specialized nursing care for tracheostomized patients and their caregiver 2. To improve patients’ QOL 3. To enhance support to tracheostomized patients with timely monitoring and consultation 4. To minimize re-admission related to poor tracheostomy care 5. To reduce the burden of healthcare system
There were seven cases included temporary tracheostomy and end tracheostomy patients recruited with totally 10 participants included the telehealth service. Old-aged home staffs and patient relatives were participated in this telehealth service. Pre and post M.C. quiz and evaluation surveys would be analyzed. Patients and their caregivers were required to complete the pre-zoom follow-up quiz as baseline data, which was used to compare with the post quiz in order to evaluate any improvement and effectiveness in terms of knowledge, self-efficacy and competence on tracheostomy or stoma care. Feedback and comments from participants were collected from the online evaluation survey feedback outcome. Data collection and findings: 1.100% answer correctly about red flag of tracheostomy / stoma care. 2.Most of the responders have 100% correct answer after the lesson. 3.Reflected the caregivers and patients understood and learned from the content related to tracheostomy care in the lesson.
