Effect of performance feedback on tracheal suctioning knowledge and skills: Randomized controlled trial

Florence Nightingale School of Nursing & Midwifery, King's College London, UK.
Journal of Advanced Nursing (Impact Factor: 1.74). 05/2009; 65(7):1423-31. DOI: 10.1111/j.1365-2648.2009.04997.x
Source: PubMed


This paper is a report of a study to determine whether individualized performance feedback improved nurses' and physiotherapists' knowledge and practice of tracheal suctioning.
Nurses' knowledge and practice of tracheal suctioning is often deficient. Whilst teaching has been shown to improve suctioning knowledge and practice, this is not sustained over time.
Ninety-five qualified healthcare professionals (nurses and physiotherapists) in two acute hospitals were randomly allocated to receive either individualized performance feedback or no additional feedback after a standardized lecture and practical demonstration of tracheal suctioning. Randomization was stratified by profession, seniority and site. Data were collected in 2005 in a clinical setting involving patients and a simulation setting. The outcome measures were knowledge and practice of tracheal suctioning, assessed by self-completion questionnaire and structured observation.
In both settings, intervention groups performed statistically significantly better in terms of knowledge (P = 0.014) and practice (P = 0.037) at final follow-up. Those who received performance feedback had statistically significantly higher knowledge (P = 0.004) and practice (P < 0.01) scores than the control group. For practice, there was also a relationship between professions (P < 0.01), with physiotherapists performing better than nurses overall, and an interaction between group and setting (P < 0.01), with performance feedback showing a stronger positive effect in the simulation setting.
Retention of knowledge and tracheal suctioning practice is improved when training is followed up by tailored feedback on performance. Further research would shed light on how long such improvements are sustained, and whether the improvements seen in a simulated setting can be generalized to clinical settings.

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Available from: Peter Donald Griffiths, May 15, 2015
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    • "Literatür incelendiğinde, trakeostomili hastalarda bakımın yaşamsal öneminin bilinmesine rağmen hemşirelerin bu konuda yeterli bilgi ve beceriye sahip olmadıkları saptanmıştır (Sevinç, 1997; Griggs, 1998; Buglass, 1999; Gratix ve ark., 2008; Day ve ark., 2009; Jayasekara, 2009; Donnelly ve Wiechula, 2009). "
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    ABSTRACT: One of the primary responsibility of nursing care is maintaining and evaluating airway patency in patients. Nurses’ knowledge is have vital importance about the complications and care, when providing airway patency with an artificial way (via endotracheal tube or tracheostomy cannula). As the origin of the word ‘tracheotomy’ comes from the Greek and refers to the cut-off trachea. Tracheotomy is making an opening between 3. and 4. cartilage rings on the front wall of trakea to maintain airway and it is one of the oldest life- saving surgical procedures. İndications for tracheotomy operation, prolonged intubation and mechanical ventilation can be listed firstly. Tracheostomy complications may occur in the weeks or months/years later following the opening of the tracheostomy. Nurses have responsibilities follow-up of prevention complications after the tracheostomy procedure. Tracheostomy nursing care of consist of; adequate and balanced nutrition, aspiration, cleaning of inner cannula, adjustment of cuff pressure (if the cannula has cuff system), prevention of peristomal skin problems and communication process. ÖzetHastalarda hava yolu açıklığını sürdürmek ve değerlendirmek hemşirelik bakımında öncelikli sorumluluklardan biridir. Hava yolu açıklığı yapay bir yol oluşturularak sağlandığında (endotrakeal tüp veya trakeostomü kanülü ile) hemşirelerin bu işlemlerin indikasyonlarına, komplikasyonlarına ve bakımına dair tüm bilgilere sahip olması yaşamsal öneme sahiptir. Trakeotomi kavramı, köken olarak Yunanca'dan gelmektedir ve kelime olarak 'trakeanın kesilmesi'ni ifade eder. Trakeotomi, hava yolu açıklığını sağlamak amacıyla trakeanın ön duvarında 3. ve 4. kıkırdak halka hizasında açıklık oluşması için yapılan işlem olarak tanımlanır ve hayat kurtarıcı olarak bilinen yöntemlerden en eskisi olarak kabul edilir. Trakeotomi işleminin endikasyonları arasında uzamış entübasyon ve mekanik ventilasyon ilk sıralarda yer alır. Trakeostomi komplikasyonları, trakeostominin açılmasını takip eden haftalar içinde ya da aylar/yıllar sonra ortaya çıkabilir. Trakeostomi işleminden sonra hastaların takibinde ve özellikle komplikasyonların önlenmesinde hemşirelerin sorumlulukları bulunmaktadır. Trakesotomili hastada hemşirelik bakımı; hastaların yeterli ve dengeli beslenmesini, trakeostomi aspirasyonunu, iç kanül temizliğini, eğer kanül kaf sistemine sahipse kaf basıncının ayarlanmasını, peristomal cilt problemlerinin önlenmesini ve iletişim sürecini kapsar.
    Full-text · Article · Nov 2015
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    • "Four of the studies had multiple arms, (Chang et al. 2007; O&apos;Connor et al. 2007; Van Sickle et al. 2007; Xeroulis et al. 2007) with comparisons between different feedback interventions, such that the contrasts (i.e., discrete comparisons) described here total more than 31. There were 18 studies that compared a feedback intervention to a control intervention with no feedback (Byrne et al. 2002; Chang et al. 2007; Day et al. 2009; Domuracki et al. 2009; Gerling and Thomas 2003; Kovacs et al. 2000; Lazarski et al. 2007; Moulton et al. 2009; O&apos;Connor et al. 2007; Pugh et al. 2001; Rafiq et al. 2008; Rosser et al. 2006; Chang et al. 2008; Spooner et al. 2007; Van Sickle et al. 2007; Wierinck et al. 2005; Xeroulis et al. 2007; Yasukawa 2009). Of the remaining included studies, three compared concurrent (feedback provided throughout each practice trial) to terminal feedback (feedback provided after each practice trial) (Chang et al. 2007; Walsh et al. 2009; Xeroulis et al. 2007) and two other studies examined reducing the frequency of concurrent feedback (Stefanidis et al. 2007; Wierinck et al. 2006a). "
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    ABSTRACT: Although feedback has been identified as a key instructional feature in simulation based medical education (SBME), we remain uncertain as to the magnitude of its effectiveness and the mechanisms by which it may be effective. We employed a meta-analysis and critical narrative synthesis to examine the effectiveness of feedback for SBME procedural skills training and to examine how it works in this context. Our results demonstrate that feedback is moderately effective during procedural skills training in SBME, with a pooled effect size favoring feedback for skill outcomes of 0.74 (95 % CI 0.38-1.09; p < .001). Terminal feedback appears more effective than concurrent feedback for novice learners' skill retention. Multiple sources of feedback, including instructor feedback, lead to short-term performance gains although data on long-term effects is lacking. The mechanism by which feedback may be operating is consistent with the guidance hypothesis, with more research needed to examine other mechanisms such as cognitive load theory and social development theory.
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    No preview · Article · Jan 2010 · Réanimation
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