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Examining pediatric emergency home ventilation practices in home health nurses: Opportunities for improved care
Sheila S Kun1, Virginia N Beas2, Thomas G Keens3
1Division of Pediatric Pulmonary, Children's Hospital Los Angeles, Los Angeles, California.
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.
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