(0260) Understanding the Surgical Airway Patient: Knowledge Gaps and Quality Improvement Among Nursing Staff

Introduction: There is a lack of understanding among healthcare staff regarding the different types of surgical airways in head and neck cancer patients including tracheostomies and laryngectomies. The objective of this study was to determine the effectiveness of a 10-minute educational video on improving knowledge gaps among nursing staff on a surgical inpatient unit.

Methods: A video demonstrating the difference between the airway in a tracheostomy patient and a laryngectomy patient was created using cadaver models. Pretest and posttest questions were created and offered via email to the nursing staff involved in the otolaryngology unit at a large teaching hospital from Mar-Apr 2023. 10 questions focused on key concepts of managing these airways and 3 measured confidence level. Wilcoxon Signed Ranks tests were used to compare responses before and after watching the video.

Results: 29 participants (25 RNs, 2 CRNAs, and 2 RN students) recorded complete results.

Before the video, 16 (55%) were very confident in managing surgical airway patients which increased to 21 (72%) after the video (p <.001). Before the video, 6 (21%) rated themselves as very knowledgeable on the anatomical differences between tracheostomy and laryngectomy patients versus 23 (79%) after the video (p <.001). 8 (28%) felt very confident in the steps to take when diagnosing an obstructed tracheostomy tube before the video versus 20 (69%) after the video (p <.001).

Prior to the video, 5 (17%) thought that a patient with a laryngectomy could be intubated from above versus 1 (3%) after the video, however this was not a statistically significant difference. There was also improvement in the number of participants selecting specific maneuvers to clear a blocked trach tube after watching the video.

Conclusions: The level of knowledge about accessing surgical airways was higher than expected in this group, however 100% of respondents did not answer correctly after watching the video. Since this knowledge can be the difference between life and death for a patient, further efforts to communicate this to healthcare workers involved in their care is needed.