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Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations
Elliot Schiff1, Evan J Propst2, Karthik Balakrishnan3
1Albert Einstein College of Medicine, Bronx, New York, USA.
The Laryngoscope
|April 28, 2023
Summary
This study developed an assessment tool for pediatric tracheostomy emergencies, integrating human and systems factors. The tool aids in evaluating and improving responses to both real and simulated critical events.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Simulation
- Patient Safety
Background:
- Pediatric tracheostomy emergencies require standardized assessment tools.
- Existing tools may not adequately incorporate human and systems factors.
- Effective management of these emergencies is crucial for patient outcomes.
Purpose of the Study:
- To achieve consensus on critical steps for pediatric tracheostomy emergencies.
- To create an assessment tool for actual and simulated events.
- To incorporate human, systems, and tracheostomy-specific factors into the tool.
Main Methods:
- Modified Delphi method with 171 experts.
- Utilized REDCap software for item circulation and rating.
- Iterative refinement based on expert feedback and consensus criteria.
Main Results:
- High response rates across three Delphi rounds (73.1% to 88.8%).
- Consensus reached on 22 items across three domains: tracheostomy steps (12), team factors (4), and equipment (6).
- 133 expert comments were incorporated into the final tool.
Conclusions:
- Developed a validated assessment tool for pediatric tracheostomy emergencies.
- The tool evaluates tracheostomy-specific steps and systems factors.
- Applicable for assessing simulated/clinical events, guiding debriefings, and driving quality improvement.
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