Enhance Patient Safety by providing Tracheostomy Care Training to all Nursing Students during their clinical practicum in Ear, Nose and Throat Ward, Tuen Mun Hospital

Abstract Description

Authors (including presenting author) :

Tang WHR(1), Law YK(1)

Affiliation :

(1) Ward A2 Ear, Nose and Throat, Tuen Mun Hospital

Introduction :

In view of recent clinical incidents related to tracheostomy care provided by nursing students, it reflects that clinical areas need to reinforce supervision on tracheostomy care during their clinical practicum. Incompetency tracheostomy care may need to significant patient harm.

Objectives :

To enhance nursing students’ (1) theoretical knowledge and (2) nursing skills on tracheostomy care. In consequence, the nursing students are able to apply their knowledge and improve their ability to integrate theory and practice.

Methodology :

Mentorship on tracheostomy care was provided by APN ENT. Theoretical knowledge input include: (1) Differentiation of tracheostomy and laryngectomy (End tracheostomy); (2) Different types of tracheostomy tubes; and (3) Subsequent care such as handling of tracheostomy emergency including tube blockage, tube dislodgement, hemorrhage and respiratory distress. Skills training include: (1) Tracheostomy dressing and changing Inner Tube; (2) Cleaning of tracheostomy tube; (3) Tracheostomy tie changing and tying steps; (4) Tracheostomy suction and (5) Measure tracheostomy tube cuff pressure by using pressure gauge. Power Point, Video and Dummy were used as teaching aids. On-hands practice is also included.
To measure the effectiveness of mentorship on tracheostomy care, qualitative data were collected by means of pre/post questionnaires, interviews, reviews, and the numbers of nursing students engaged in Mentorship Program.

Result & Outcome :

From Jun 2017 to Sep 2018, 28 nursing students were participated in the mentorship program with pre/post questionnaires completed. One of them dropped off. Knowledge in tracheostomy care through clinical practicum is gained from pre score 2.62 to post score 3.78. Over 95% of them welcomed with the aids of video to demonstrate cleaning of tracheostomy tube, tracheostomy tie changing and tying steps. 100% of nursing students rated at 4 or above on the mentorship program and express had achieved the knowledge, skills and competence required in tracheostomy care.
In conclusion, the feedbacks from nursing students provided solid evidence in supporting the mentorship program. Although day-to-day working environment is challenging, enriching nursing students competence which ultimately benefit patient with quality and safety.