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. 2020 Sep-Oct;41(5):102574.
doi: 10.1016/j.amjoto.2020.102574. Epub 2020 Jun 1.

Rapid implementation of COVID-19 tracheostomy simulation training to increase surgeon safety and confidence

Phillip S LoSavio  1 , Michael Eggerstedt  2 , Bobby A Tajudeen  1 , Peter Papagiannopoulos  1 , Peter C Revenaugh  1 , Pete S Batra  1 , Inna Husain  1
Affiliations

Rapid implementation of COVID-19 tracheostomy simulation training to increase surgeon safety and confidence

Phillip S LoSavio et al. Am J Otolaryngol. 2020 Sep-Oct.

Abstract

Objective: To determine if rapid implementation of simulation training for anticipated COVID-19 tracheostomy procedures can increase physician confidence regarding procedure competency and use of enhanced personal protective equipment (PPE).

Methods: A brief simulation training exercise was designed in conjunction with the development of a COVID-19 Tracheostomy Protocol. The simulation training focused primarily on provider safety, pre and post-surgical steps and the proper use of enhanced PPE. Simulation training was performed in the simulation lab at the institution over 2 days. Pre and post self-evaluations were measured using standardized clinical competency questionnaires on a 5-point Likert Scale ranging from "No knowledge, unable to perform" up to "Highly knowledgeable and confident, independent."

Results: Physicians self-reported a significant increase in knowledge and competency immediately after completing the training exercise. Resident physicians increased from a mean score of 3.00 to 4.67, p-value 0.0041, mean increase 1.67 (CI 95% 0.81 to 2.52). Attending physicians increased from a mean score of 2.89 to 4.67, p-value 0.0002, mean increase 1.78 (CI 95% 1.14 to 2.42). Overall, all participants increased from a mean score of 3.06 to 4.71, p-value 0.0001, mean increase 1.65 (CI 95% 1.24 to 2.05).

Discussion: Implementation of this simulation training at our institution resulted in a significant increase in physician confidence regarding the safe performance of tracheostomy surgery in COVID-19 patients.

Implications for practice: Adoption of standardized COVID-19 tracheostomy simulation training at centers treating COVID-19 patients may result in improved physician safety and enhanced confidence in anticipation of performing these procedures in real-life scenarios.

Keywords: Airway; COVID-19; PPE; PSQI; Safety; Simulation; Tracheostomy.

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Conflict of interest statement

Declaration of competing interest None.

Figures

Fig. 1
Fig. 1
Rush University Medical Center COVID-19 tracheostomy protocol.
Fig. 2
Fig. 2
CAPR® devices with charging stand allocated for dedicated use by the Otolaryngology Service.
Fig. 3
Fig. 3
CAPR® device in use during simulation training exercise.
Fig. 4
Fig. 4
Clinical competency questionnaire self-reporting tool.
Fig. 5
Fig. 5
Protocol script for simulation training – donning and doffing enhanced PPE.
Fig. 6
Fig. 6
Clinical competency questionnaire results pre and post training.
See this image and copyright information in PMC

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