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Published on: January 17, 2011
Standardized Extubation and High Flow Nasal Cannula Training Program for Pediatric Critical Care Providers in Lima,
Laura E Ellington1, Rosario Becerra Velásquez2, José Tantaleán da Fieno2
1Fellow, Pediatric Pulmonary and Sleep Medicine, University of Washington.
Insights
This study developed and tested training modules for pediatric respiratory support in Peru. The curriculum successfully trained healthcare providers, improving their comfort and proficiency with new technologies.
Area of Science:
- Pediatric Critical Care
- Medical Education Technology
- Global Health Initiatives
Background:
- Acute lower respiratory tract infections are a leading cause of mortality in children under five globally.
- Resource-limited settings often lack sustainable pediatric respiratory support, hindering effective patient care.
- Previous technology implementations have faced challenges with long-term local staff adoption and comfort.
Purpose of the Study:
- To develop and implement standardized training modules for extubation and high flow nasal cannula use.
- To enhance the skills and confidence of healthcare providers in managing pediatric respiratory conditions.
- To create a sustainable model for introducing respiratory technology in resource-limited tertiary care centers.
Main Methods:
- A year-long training curriculum combining didactic lectures, hands-on practice, and case discussions was designed.
- Training materials were developed in English and translated into Spanish for local applicability.
- The program targeted physicians, nurses, residents, and medical technicians in a tertiary care setting.
Main Results:
- 76 healthcare providers, including physicians, nurses, residents, and technicians, participated.
- 99% of participants reported clearly stated training objectives.
- 92% of participants felt the training objectives were met, indicating successful knowledge transfer.
Conclusions:
- The developed training curriculum effectively equipped healthcare providers with essential respiratory support skills.
- The modular approach allows for adaptation to different institutional needs and learner levels.
- This initiative offers a scalable model for improving pediatric respiratory care in resource-limited environments.
Introduction:
Acute lower respiratory tract infections are the top cause of nonneonatal mortality in children under 5 years of age. Since many resource-limited settings lack basic pediatric respiratory support modalities, introducing respiratory technology in these settings may improve survival. Unfortunately, data suggest that many interventions in these settings are not sustainable and that after several months, local staff are no longer comfortable using newly implemented technology.
Methods:
We aimed to create training modules for implementation of a standardized extubation process and high flow nasal cannula for physician and nurse providers at a tertiary care center in Lima, Peru. This training curriculum combined a didactic lecture with hands-on practicum and clinical case discussion over multiple sessions spanning a year. We created all materials in English and translated to Spanish for use. Participants completed evaluations after the training program to determine whether objectives were met. This training was intended for critical care providers but could be modified for other audiences.
Results:
A total of 76 providers (12 attending/fellow critical care physicians, 40 bedside nurses, eight pediatric residents, and 14 medical technicians) participated in this multiday training. Almost all (75, 99%) participants felt the objectives were clearly stated, and 70 (92%) felt objectives were met.
Discussion:
We have provided materials to help instructors set up and implement a standardized training curriculum with recommended timing and improvements based on feedback. The tools provided allow for adaptation depending on the instructors' primary objectives, language of audience (English or Spanish), and learners' level of training.
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