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Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations
Journal article   Open access   Peer reviewed

Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations

Elliot Schiff, Sohit P. Kanotra, Evan J. Propst, Karthik Balakrishnan, Kaalan Johnson, David W. Lounsbury, Michael J. Brenner, Marc-Mina Tawfik, Jeffrey P. Simons, Eric Moreddu, …
The Laryngoscope, Vol.133(12), pp.3588-3601
12/01/2023
DOI: 10.1002/lary.30674
PMCID: PMC10710770
PMID: 37114735
url
https://scholarsphere.psu.edu/resources/73ad1d4d-17b5-4d69-a97d-fe371413eca6/downloads/33081View
Open Access

Abstract

Objective: To achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems factors along with tracheostomy-specific steps. Methods: A modified Delphi method was used. Using REDCap software, an instrument comprising 29 potential items was circulated to 171 tracheostomy and simulation experts. Consensus criteria were determined a priori with a goal of consolidating and ordering 15 to 25 final items. In the first round, items were rated as "keep" or "remove". In the second and third rounds, experts were asked to rate the importance of each item on a 9-point Likert scale. Items were refined in subsequent iterations based on analysis of results and respondents' comments. Results: The response rates were 125/171 (73.1%) for the first round, 111/125 (88.8%) for the second round, and 109/125 (87.2%) for the third round. 133 comments were incorporated. Consensus (>60% participants scoring >= 8, or mean score >7.5) was reached on 22 items distributed across three domains. There were 12, 4, and 6 items in the domains of tracheostomy-specific steps, team and personnel factors, and equipment respectively. Conclusions: The resultant assessment tool can be used to assess both tracheostomy-specific steps as well as systems factors affecting hospital team response to simulated and clinical pediatric tracheostomy emergencies. The tool can also be used to guide debriefing discussions of both simulated and clinical emergencies, and to spur quality improvement initiatives.
Life Sciences & Biomedicine Medicine, Research & Experimental Otorhinolaryngology Research & Experimental Medicine Science & Technology

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