Dr Jennifer Arnold (Baylor Coll)

1. ALERT Presentation: Title
Shilpa Hundalani, Jenny Gonzales, Jennifer Arnold
Baylor College of Medicine, Texas Children’s Hospital
IMSH 2013: Orlando, Florida / USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background
• Some survivors of neonatal intensive care are left with comorbid
conditions that require dependence on medical devices for transition
out of the hospital.
– Special subset : Infants requiring tracheostomies (1)
• More parents caring for sick infants in their home environments (2)
– Advanced home technology
– Family centered care
– Increases in insurance and hospital costs
– Absence of chronic care facilities
• Caregiver education gap in dealing with tracheostomy
emergencies
International Network for Simulation-based Pediatric Innovation, Research and Education

3. PICO Question
• P: For primary caregivers of high risk technology dependent infants
being discharged from the NICU with tracheostomies
• I: Does a Simulation-based training program regarding common
airway and tracheostomy emergencies parent’s encounter at home
• C: Compared to current bedside discharge teaching
• O: Improve skills and ability to manage tracheostomy related
airway emergencies in the simulated environment, improve parental
confidence and decrease parental anxiety and stress, and ultimately
decrease unnecessary hospital re-admissions within 72hrs related to
tracheostomy emergencies
International Network for Simulation-based Pediatric Innovation, Research and Education

4. Approach / Design
• 3 phases :
– 1. Retrospective chart Review
• Indications, surgical timing, length of stay, and discharge dispositions and early readmission
rates of infants discharged from NICU with tracheostomies over last year.
– 2. Simulation based intervention training for caregivers
with infants being discharged home with tracheostomies.
(current proposal for a multicenter study)
– 3. Prospective follow up post discharge : to evaluate
impact of the simulation training program.
• Inclusion criteria
– Parents or primary caregivers of infants who have never been
home and whose infant is being discharged from the NICU with a
tracheostomy.
International Network for Simulation-based Pediatric Innovation, Research and Education

5. 3 Questions to improve study
1. What might be the best outcome measures to help
identify the study aims?
2. Ideas related to logistics of involving parents as
subjects of simulation-based training?
3. Could this be a multi-centered project?
4. Refining study design
International Network for Simulation-based Pediatric Innovation, Research and Education

6. Contact Information
Name Jennifer Arnold
Institution Baylor College of Medicine
E-mail, Phone jlarnold@bcm.edu/ 832-
824-1480
Website / QR Code
www.texaschildrenshospital.org
International Network for Simulation-based Pediatric Innovation, Research and Education