Nurse practitioner-led telehealth to improve outpatient pediatric tracheostomy management in South Texas

Pediatric tracheostomy patients are a medically complex population with increased incidence of emergency room (ER) use, hospital readmissions, tracheostomy-associated complications, and caregiver anxiety, especially the 30 days following discharge. The objective of this quality improvement (QI) initiative was to improve access to and quality of care for vulnerable, underserved populations by providing a Nurse Practitioner-led telehealth intervention. Method: This pilot feasibility study utilized a one-group, pre-test, post-test, quasi-experimental, retrospective cohort design in a free-standing pediatric hospital serving underserved populations using the Caregiver Knowledge Checklist, Care Transitions Measures Survey, Telehealth Satisfaction Survey, and Trach Care Behavior Scale. Results: Participants experienced no post-surgical tracheostomy complications or hospital readmissions with improved scores on all survey instruments, resulting in changed department clinical practice guidelines using telehealth. Discussion: Telehealth is effective in managing outpatient tracheostomy patients, supporting caregivers, and refining proficiency caring for tracheostomy-dependent children. Telehealth is accessible, affordable, and effective in improving outcomes.