Examining pediatric emergency home ventilation practices in home health nurses: Opportunities for improved care

Summary Objectives To assess the pediatric home health nurses' knowledge in tracheostomy and ventilator emergency care on home mechanical ventilation (HMV). Background Emergencies are frightening experiences for solo home health nurses and require advanced skills in emergency response and care, especially in pediatric patients who pose unique challenges. Working Hypothesis Nurses with greater years of nursing experience would perform better on emergency HMV case-based scenarios than nurses with less years of experience. Study Design An exploratory online survey was used to evaluate emergency case-based pediatric scenarios. Demographic and professional experiences were profiled. Patient-subject Selection Seventy-nine nurses had an average of 6.73 (SD = 1.41) years in pediatric nursing. Over 70% received their HMV training in their agency, 41% had less than 4 years of experience, and 30.4% had encountered at least one emergency situation at home. Methodology The online survey was distributed by managers of 22 home health agencies to nurses providing pediatric HMV care. Results Nurses scored an average of 4.87 out of 10 possible points. There were no significant differences between nurses with <4 years of experience versus those with more experience on ventilator alarms knowledge or total knowledge. Ninety-seven percent of the nurses favored more training in HMV from a variety of settings (e.g., agency, on-line training). Conclusions Nurses did not perform well in case-based ventilator alarm scenarios. Length of nursing experience did not differentiate greater knowledge. It is clear that nurses require and want more training in emergency-based HMV. Recommendations for an enhanced curriculum are suggested. Pediatr Pulmonol. 2015; 50:691–697. © 2014 Wiley Periodicals, Inc.