Promoting the Effectiveness of Tracheostomy Nursing Instruction in the Intensive Care Unit

Background： There are common diagnoses of stroke, myasthenia gravis, acute or chronic demyelinating inflammatory neuritis in the neurological intensive care unit. These diseases may affect the conscious and breathing pattern of the patients. Then the patients cannot be quickly weaning the ventilator and removing the endotracheal tube. In this case, tracheostomy improves the patients comfort and help them successfully weaning the ventilator, but in Taiwan’s traditional culture most people refuses tracheostomy. As a result, it is very important that effective nursing instruction about tracheostomy is provided.

Objective：This study investigated the difficulties encountered in the method of traditional paper in the neurological intensive care unit and evaluated the effectiveness of the creative design of the hand puppet as an actual sample.

Methods: Twenty-five nurses participated in the questionnaire survey at a medical center of southern Taiwan. Their experience of nursing instruction based on the creative design tool and the traditional paper is compared.

Results：About 60% of the participants adopt the method of the traditional paper in terms of the nursing instruction of tracheostomy and their satisfaction was 20% while the patients or family’s cognitive of tracheostomy was only 40%. On the other hand, about 40% of the participants adopt the method of the creative design of the hand puppet as an actual sample in terms of the nursing instruction of tracheostomy and their satisfaction was 90% while the patients or family cognitive of tracheostomy enhanced to over 90%. All nurse consent that the creative design of the hand puppet as an actual sample can help families or patients to understand tracheostomy. In addition, it is very convenient to use for clinical nurses in terms of nursing instruction.

Conclusion：The current study demonstrated that creative design of the hand puppet as an actual sample can provide nurses with easy nursing instruction and enhance families or patients knowledge in hopes to accept tracheostomy. Early tracheostomy not only improves the quality of life but also reduces the length of hospital stays. The author recommends developing more creatively designed teaching tools to promote the quality of nursing care.