Otolaryngologists’ Initiative for Collaborative Tracheostomy Care: Knowledge, Attitude and Skill in Tracheostomy Care Among Nurses - An Interventional Study from India

Introduction: Tracheostomy-related adverse events are a global problem, requiring coordinated approach for care of tracheostomised patients. The concept of ‘collaborative tracheostomy care’ was introduced by Global Tracheostomy Collaborative in 2012. For successful post tracheostomy outcome, nursing care is vital. Data on their knowledge, attitude and skills regarding tracheostomy care including outcome of a structured interventional workshop is not available from India. Methods: A validated questionnaire with items pertaining to knowledge, attitude and skills regarding tracheostomy care was administered to nurses working in intensive care units and wards. Following this, a workshop was conducted for hands-on training in tracheostomy care using didactic lectures, videos and simulation-based training. The participants took a post-test immediately and after three months. Skills were assessed before and three months after the workshop using a checklist. Results: Among 386 participants who attended the pre-test and workshop, 285 (74.2%) underwent post-test immediately and three months later. Overall mean knowledge score (± SD) of the participants in pre-workshop was 6.8 ± 3.5, immediate post-test score was 15.9 ± 2.7 and three months later was 11.6 ± 3.5 (p < 0.001) out of total score 20. The baseline score was significantly higher among ICU nurses. Three months post workshop skill assessment revealed no statistically significant increase in the proportion of participants who performed skills related to suctioning procedure. Conclusion: Knowledge, attitude and practice regarding tracheostomy care is inadequate among nurses. Otolaryngologists-driven structured intervention with didactic lectures, videos and hands-on training can improve all three domains to positively impact outcomes in post tracheostomy patient care.