Randomised Controlled Trial of a Pediatric Tracheostomy Care Education
Program for Homecare Nurses
Abstract
Objective: To evaluate the immediate and sustained knowledge retention
and sense of self-efficacy of homecare nurses following completion of a
standardized competency-based tracheostomy education course. Safe
discharge of children requiring tracheostomy with or without ventilation
relies on the competence of homecare nurses. Study Design: Pragmatic,
randomized controlled trial of 44 homecare nurses. Participants were
randomized into the intervention group (n=21), which received the
tracheostomy course, or the control group (n=23), which received an
enterostomy and vascular access course. Multiple-choice question (MCQ)
knowledge assessments and self-efficacy questionnaires were administered
to both groups pre-course and post-course at 6 week, 3 month, 6 month,
and 12 month follow-ups. Results: Twenty participants in the
intervention group and 19 in the control group were included. Four
withdrew from the study and two crossed over from the control into the
intervention arm. The change in mean self-efficacy scores (total score =
100) was significantly higher in the intervention group than in the
control group at 6 weeks (intervention (mean ± SD): 18.6±14.5; control:
6.6±20.4; p=0.04) and 3 months (intervention: 19.6±14.2; control:
5.2±17.0; p=0.007), and trended higher at 6 months (intervention:
18.0±14.5; control: 6.9±24.1; p=0.1) and 12 months (intervention:
16.9±15.0; control: 16.8±20.5; p=1.0). The change in mean MCQ assessment
scores (total score = 20) trended higher in the intervention group than
in the control group at 6 weeks (intervention (mean ± SD): 1.8±2.2;
control: 1.6, ±2.9; p=0.8). Conclusions: Homecare nurses who attended
the tracheostomy course demonstrated a higher sense of self-efficacy at
long-term follow-up.