An Education Program for the Care of the child with a Tracheostomy: A Model for Collaboration with Community Agencies

1. An Education Program for the Care of the child with a Tracheostomy: A Model for Collaboration with Community Agencies Marilyn Krell, RN, MSN, CRRN Tracheostomy Specialty Nurse CHOC Children�s Hospital

2. Objectives Improve continuity and consistency of care of children with complex medical needs Identify strategies to assure community health care providers have current knowledge of standards of care for medical diagnoses Enhance education or parents/caregivers Collaborate with community caregivers to provide evidence-based care at home/school

3. Objectives - continued Develop communication network between hospital and community agencies for continuity of care Discuss methods of education to integrate hospital training and care to the community setting

4. Why is this Important? Most education programs designed for hospital care. Home care nurses and school nurses are not updated on changes in hospital procedures that are evidence- based. Contact person for school/home nurses Goal � Keep the Kids home

5. Background of Collaboration Orange County Department of Education � asked for review of policies/procedures for Tracheostomy patients. Home Health agencies needed clarification of care instructions for parents. Opportunity for funds from Children�s Miracle Network

6. Development of the Workshop

7. Planning Sessions Close contact with School Liaison for their needs Department of Clinical Excellence (Nursing Education) Physician Input � Pulmonologist and ENT Collaboration with Speech Therapy and Respiratory Therapy

8. Vendor Support Contacted two of most used respiratory vendors: Provided lunches for all workshops Supplied equipment for practice stations Therapist provided lecture on ventilators Both vendors had staff at practice stations

9. Publicity Contact target audience E-mailed announcement Placed in School Nurse Newsletter Phone Calls to Home Health Agencies

10. Registration for Workshops E-mail registration Confirmation by e-mail Follow-up reminder for workshop by e-mail

11. Workshops

12. Care of the Pediatric Tracheostomy and Ventilator Patient in the Community � 7:30 Registration 8:00 Welcome, Overview 8:15 Physician Welcome 8:30 Trachs � Basics 101 9:30 Break 9:45 Ventilators and Other Machines 11:15 Passy-Muir Valve 12:00 Lunch �1:00 On the Road �1:15 Practice Stations - Trachs, Ventilators, Suction, Trach care , Passy-Muir �2:45 Break 3:00 Supplies � What Is Covered �3:30 Orders � How To Get Them Signed 4:00 Open Forum � Questions, Evaluation �

13. Multidisciplinary Approach

22. Hands on Practice

29. Results of Workshops

30. Participation February Workshop - 68 attendees - School Nurses � 55, Home Health Nurses 13 May Workshop � 62 attendees - School Nurses � 56, Home Health Nurses 6 August Workshop � 82 attendees - School Nurses � 40, Home Health Nurses 42

31. Knowledge Check Pretests February Workshop - 50 % correct answers May Workshop � 57 % correct answers August Workshop - 60 % correct answers Posttests February Workshop - 99 % correct answers May Workshop - 9 7 % correct answers August Workshop � 97 % correct answers

32. Hospital as a Resource School nurses and home health agencies have resource for questions regarding care Nurses are referring potential problems. Open communication with community partners

33. Applicability to Other Services

34. Was it worth the effort? Story of One Child

35. Questions?