The purpose of this study is to identify and establish a safe and effective tracheostomy teaching protocol for caregivers. Results of this study will help in the development of a discharge protocol that allows for caregiver confidence and activation in tracheostomy care for patients.
This is a 3-phase, prospective controlled cohort study . The first "pre-implementation" phase will include assessment of healthcare utilization costs of tracheostomy patients currently and nursing perspective on current caregiver tracheostomy knowledge. The second "protocol" phase will include assessment of the necessity, acceptability, feasibility, fidelity, safety and effectiveness of a standardized pathway and assessment of the caregiver's activation. The third "post-implementation" phase will involve assessment of post-implementation tracheostomy-related healthcare utilization costs and nursing perspective on caregiver tracheostomy knowledge.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Tracheostomy education booklet and tracheostomy teaching performed by nurses during hospitalization as dictated by the booklet.
University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center
Cleveland, Ohio, United States
Patient-Caregiver Activation Survey scores
Caregiver activation in managing their family members' tracheostomy after implementation of a standardized discharge program as measured by the Patient-Caregiver Activation Survey. This is a validated survey assessing caregiver consisting of 13 questions designed to determined confidence in taking care of their loved one. Scores range from 4 to 52, with higher score indicates higher degree of caregiver activation
Time frame: At time of surgery, an average of 15 minutes
Patient-Caregiver Activation Survey scores
Caregiver activation in managing their family members' tracheostomy after implementation of a standardized discharge program as measured by the Patient-Caregiver Activation Survey. This is a validated survey assessing caregiver consisting of 13 questions designed to determined confidence in taking care of their loved one. Scores range from 4 to 52, with higher score indicates higher degree of caregiver activation
Time frame: At discharge (an average of 7 days after surgery), an average of 15 minutes
Patient-Caregiver Activation Survey scores
Caregiver activation in managing their family members' tracheostomy after implementation of a standardized discharge program as measured by the Patient-Caregiver Activation Survey. This is a validated survey assessing caregiver consisting of 13 questions designed to determined confidence in taking care of their loved one. Scores range from 4 to 52, with higher score indicates higher degree of caregiver activation
Time frame: At first follow-up (1 week after discharge), an average of 15 minutes
Feasibility Questionnaire scores
The feasibility questionnaire evaluates the necessity, acceptability and feasibility of the of the implementation of a standardized discharge program. Questions are related to readiness and willingness to participate in tracheostomy care. It will assess feasibility in attending tracheostomy teaching sessions by nurses and their baseline comfort in tracheostomy care and their enthusiasm in learning tracheostomy care. Questionnaire consists of 12 questions, with scores ranging from 12 to 60, with higher scores indicating higher feasibility of tracheostomy protocol implementation.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: At time of surgery, an average of 15 minutes
Patient Reported Outcomes Measurement Information System (PROMIS) short form scores
Safety, as measured by the PROMIS scores - 7-item questionnaire that assess self-reported anxiety in the family caregiver. A higher score correlates with a higher level of anxiety. Scores range from 7 to 25, with higher scores indicating a greater severity of anxiety
Time frame: At time of surgery, an average of 15 minutes
Patient Reported Outcomes Measurement Information System (PROMIS) short form scores
Safety, as measured by the PROMIS scores - 7-item questionnaire that assess self-reported anxiety in the family caregiver. A higher score correlates with a higher level of anxiety. A higher score correlates with a higher level of anxiety. Scores range from 7 to 25, with higher scores indicating a greater severity of anxiety
Time frame: At discharge (an average of 7 days after surgery), an average of 15 minutes
Patient Reported Outcomes Measurement Information System (PROMIS) short form scores
Safety, as measured by the PROMIS scores - 7-item questionnaire that assess self-reported anxiety in the family caregiver. A higher score correlates with a higher level of anxiety. A higher score correlates with a higher level of anxiety. Scores range from 7 to 25, with higher scores indicating a greater severity of anxiety
Time frame: At first follow-up (1 week after discharge), an average of 15 minutes
Preparedness Caregiver Scale (PCS)
PCS scores - Response categories correspond to the level of preparedness. Scale consists of 9 questions, with scores ranging from 0 to 4 with high score indicating the more prepared the caregiver feels for caregiving.
Time frame: At discharge (an average of 7 days after surgery), an average of 15 minutes
Preparedness Caregiver Scale (PCS)
PCS scores - Response categories correspond to the level of preparedness. Scale consists of 9 questions, with scores ranging from 0 to 4 with high score indicating the more prepared the caregiver feels for caregiving.
Time frame: At first follow-up (1 week after discharge), an average of 15 minutes
Tracheostomy Care Competency Assessment
Effectiveness will be measured with the tracheostomy care competency assessment. This survey will be an individual's subjective assessment of his or her knowledge of tracheostomy care. A 5-point Likert scale will be used from 1 "strongly disagree" to 5 "strongly agree" and assess different aspects of tracheostomy care outlined during their tracheostomy teaching provided by nurses. This assessment includes 12 questions with scores ranging from from 12 to 60 with higher scores indicating higher competency. Results form pre-implementation to post-implementation will be compared using a paired t-test or McNemar tes
Time frame: At discharge (an average of 7 days after surgery), an average of 15 minutes
Tracheostomy Care Competency Assessment
Effectiveness will be measured with the tracheostomy care competency assessment. This survey will be an individual's subjective assessment of his or her knowledge of tracheostomy care. A 5-point Likert scale will be used from 1 "strongly disagree" to 5 "strongly agree" and assess different aspects of tracheostomy care outlined during their tracheostomy teaching provided by nurses. This assessment includes 12 questions with scores ranging from from 12 to 60 with higher scores indicating higher competency. Results form pre-implementation to post-implementation will be compared using a paired t-test or McNemar tes
Time frame: At first follow-up (1 week after discharge), an average of 15 minutes
Average tracheostomy-related healthcare utilization costs
Effectiveness will be measured with the tracheostomy care competency assessment. This survey will be an individual's subjective assessment of his or her knowledge of tracheostomy care. A 5-point Likert scale will be used from 1 "strongly disagree" to 5 "strongly agree" and assess different aspects of tracheostomy care outlined during their tracheostomy teaching provided by nurses. This assessment includes 12 questions with scores ranging from from 12 to 60 with higher scores indicating higher competency. Results form pre-implementation to post-implementation will be compared using a paired t-test or McNemar tes
Time frame: Pre-implementation (up to 6 months prior to surgery)
Average tracheostomy-related healthcare utilization costs
Average pre and post-implementation tracheostomy-related healthcare utilization costs
Time frame: Post-implementation, 30 days after discharge
Nursing survey
Effectiveness will be measured with the Nursing Survey scores. This is an 11 question survey designed to capture the amount of phone calls nurses receive regarding tracheostomy related questions over the last 6 months. Results form pre-implementation to post-implementation will be compared using a paired t-test or McNemar tes
Time frame: Pre-implementation (up to 6 months prior to surgery)
Nursing survey
Effectiveness will be measured with the Nursing Survey scores. This is an 11 question survey designed to capture the amount of phone calls nurses receive regarding tracheostomy related questions over the last 6 months. Results form pre-implementation to post-implementation will be compared using a paired t-test or McNemar tes
Time frame: Post-implementation, 30 days after discharge
Number of emergency department visits, urgent care or outpatient appointments post-discharge
Number of emergency department visits, urgent care or outpatient appointments, relating to post-discharge assessment of feasibility and safety of intervention
Time frame: Post-implementation, 30 days after discharge
Average number of tracheostomy-related phone calls per week post-discharge
Post-discharge assessment of feasibility, as measured by average number of tracheostomy-related phone calls per week
Time frame: Post-implementation, 30 days after discharge