Tracheostomy Training Survey – Assessing the Need for Education Dr Andrew McKechnie Dr Tom Bishop, Dr Shona Love, Dr Jay Dasan Kings College Hospital, London Background The National Tracheostomy Safety Project (NTSP) stresses the importance of appropriate training in tracheostomy care. The project has developed a range of E learning modules in association with the Department of Health. They also promote the use of emergency algorithms for tracheostomy management. Its website is a great resource and has links to other interested groups such as the Global Treacheostomy Collaborative. As a senior anaesthetic registrar with an interest in airway management and education I decided to assess the current tracheostomy training situation at Kings College Hospital, London. The aim was to assess and analyse trainee knowledge of the management of tracheostomy patients and to implement change to improve patient safety. . An online survey was devised to determine the level of knowledge in treating tracheostomy patients. The survey was distributed to 25 anaesthetic and ITU trainees. The questions were designed to focus on key areas of management such as the recognition and treatment of tracheostomy emergencies, the recognition of complications and the measures to prevent them occurring. In addition the survey asked specifically about the knowledge of national guidelines. To assess the educational need there was a question asking if ANY formal training had been received previously and if more focused References Project Goals Method Action Plan The results are concerning. The plan is to initiate a full training module to include all aspects of tracheostomy management. There will be lectures, workshops and simulation with pre and post course assessment. In addition the NTSP emergency guidelines will be placed above every ITU bed space. 1) www.tracheostomy.org.uk 2) Reproduced from McGrath BA, Bates L, Atkinson D, Moore JA. Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies. Anaesthesia. 2012 Jun 26. doi: 10.1111/j.1365-2044.2012.07217, with permission from the Association of Anaesthetists of Great Britain & Ireland/Blackwell Publishing Ltd." 3) Email [email protected] 089 K The grade of trainees ranged from doctors in their first ITU post to senior anaesthetic registrars. As a result the level of knowledge varied greatly on recognition and management of emergencies. However, in almost all areas this level was deemed inadequate. Knowledge of ITU measures to reduce and prevent complications was low and that of “red flags” was less than expected. Even basic knowledge regarding the types of tracheostomy tubes available was poor. A worrying 68% of trainees had NEVER received any formal training in management of tracheostomy patients. Although 85% claimed to be aware of national guidelines, many of the responses suggested otherwise. 90% replied they would benefit from further training in tracheostomy management. Results

Tracheostomy Training Survey – Assessing the Need for Education Dr Andrew McKechnie Dr Tom Bishop, Dr Shona Love, Dr Jay Dasan Kings College Hospital,

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Tracheostomy Training Survey – Assessing the Need for Education

Dr Andrew McKechnieDr Tom Bishop, Dr Shona Love, Dr Jay Dasan

Kings College Hospital, London

Background

The National Tracheostomy Safety Project (NTSP) stresses the importance of appropriate training in tracheostomy care. The project has developed a range of E learning modules in association with the Department of Health. They also promote the use of emergency algorithms for tracheostomy management. Its website is a great resource and has links to other interested groups such as the Global Treacheostomy Collaborative. As a senior anaesthetic registrar with an interest in airway management and education I decided to assess the current tracheostomy training situation at Kings College Hospital, London.

The aim was to assess and analyse trainee knowledge of the management of tracheostomy patients and to implement change to improve patient safety.

An online survey was devised to determine the level of knowledge in treating tracheostomy patients. The survey was distributed to 25 anaesthetic and ITU trainees. The questions were designed to focus on key areas of management such as the recognition and treatment of tracheostomy emergencies, the recognition of complications and the measures to prevent them occurring. In addition the survey asked specifically about the knowledge of national guidelines. To assess the educational need there was a question asking if ANY formal training had been received previously and if more focused tracheostomy teaching would be of benefit.

References

Project Goals

Method

Action Plan

The results are concerning. The plan is to initiate a full training module to include all aspects of tracheostomy management. There will be lectures, workshops and simulation with pre and post course assessment. In addition the NTSP emergency guidelines will be placed above every ITU bed space.

1) www.tracheostomy.org.uk

2) Reproduced from McGrath BA, Bates L, Atkinson D, Moore JA. Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies. Anaesthesia. 2012 Jun 26. doi: 10.1111/j.1365-2044.2012.07217, with permission from the Association of Anaesthetists of Great Britain & Ireland/Blackwell Publishing Ltd."

3) Email [email protected]

089K

The grade of trainees ranged from doctors in their first ITU post to senior anaesthetic registrars. As a result the level of knowledge varied greatly on recognition and management of emergencies. However, in almost all areas this level was deemed inadequate. Knowledge of ITU measures to reduce and prevent complications was low and that of “red flags” was less than expected. Even basic knowledge regarding the types of tracheostomy tubes available was poor.A worrying 68% of trainees had NEVER received any formal training in management of tracheostomy patients. Although 85% claimed to be aware of national guidelines, many of the responses suggested otherwise.90% replied they would benefit from further training in tracheostomy management.

Results