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Pediatr Pulmonol. 2015 Jul;50(7):691-7. doi: 10.1002/ppul.23040. Epub 2014 Apr 7.

Examining pediatric emergency home ventilation practices in home health nurses: Opportunities for improved care.

Author information

1
Division of Pediatric Pulmonary, Children's Hospital Los Angeles, Los Angeles, California.
2
Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California.
3
Keck School of Medicine, University of Southern California, Los Angeles, California.

Abstract

OBJECTIVES:

To assess the pediatric home health nurses' knowledge in tracheostomy and ventilator emergency care on home mechanical ventilation (HMV).

BACKGROUND:

Emergencies are frightening experiences for solo home health nurses and require advanced skills in emergency response and care, especially in pediatric patients who pose unique challenges.

WORKING HYPOTHESIS:

Nurses with greater years of nursing experience would perform better on emergency HMV case-based scenarios than nurses with less years of experience.

STUDY DESIGN:

An exploratory online survey was used to evaluate emergency case-based pediatric scenarios. Demographic and professional experiences were profiled.

PATIENT-SUBJECT SELECTION:

Seventy-nine nurses had an average of 6.73 (SD = 1.41) years in pediatric nursing. Over 70% received their HMV training in their agency, 41% had less than 4 years of experience, and 30.4% had encountered at least one emergency situation at home.

METHODOLOGY:

The online survey was distributed by managers of 22 home health agencies to nurses providing pediatric HMV care.

RESULTS:

Nurses scored an average of 4.87 out of 10 possible points. There were no significant differences between nurses with <4 years of experience versus those with more experience on ventilator alarms knowledge or total knowledge. Ninety-seven percent of the nurses favored more training in HMV from a variety of settings (e.g., agency, on-line training).

CONCLUSIONS:

Nurses did not perform well in case-based ventilator alarm scenarios. Length of nursing experience did not differentiate greater knowledge. It is clear that nurses require and want more training in emergency-based HMV. Recommendations for an enhanced curriculum are suggested.

KEYWORDS:

home mechanical ventilation; pediatric; tracheostomy

PMID:
24706404
DOI:
10.1002/ppul.23040
[Indexed for MEDLINE]

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