1. Progress Report Presentation:
Using Simulation to improve parent preparedness for
medically complex infants at discharge from the NICU
‘PEP-TALC’ – Parent emergency preparedness in
tracheostomy assisted living and care
Shilpa Hundalani, Jennifer Arnold
Baylor College of Medicine, Texas Children’s Hospital
IMSH 2014: San Francisco, CA / USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Aim(s) - Revised
•
P: For primary caregivers of high risk ventilator dependent infants being
discharged from the NICU with tracheostomies
• I: Does a Simulation-based training program regarding common airway
and tracheostomy emergencies parent’s encounter at home
• C: Compared to current bedside discharge teaching
• O: 1. Improve caregiver preparedness for discharge from the NICU by
a. Improved cognitive, technical, and behavioral skills in their ability
to manage tracheostomy related airway emergencies in a simulation based
environment as assessed by a performance checklist of critical behaviors
b. Increased self-efficacy as assessed by a survey pre and post
simulation training
2. Decrease unnecessary hospital re-admissions within 1 week related
to tracheostomy emergencies as assessed by EPIC chart review and survey
follow up at 4-6 weeks post discharge
International Network for Simulation-based Pediatric Innovation, Research and Education

3. Progress since Jan 2013
•
January – June 2013 :
•
Scenarios and outcome tools developed:
• Multidisciplinary input including parent feedback and review from the Center
for Advancing Perinatal Education (CAPE) simulation research group
•
Funding obtained:
• Baylor Advancing Clinical Excellence (ACE) Health care Trainee
Grant: $2500
• Internal support for purchase of SimBaby manikin
•
Manikin modified with a tracheostomy:
•Special Thanks to the Bristol Pediatric Simulation Center
•
Scenario practice sessions with parents of infants with tracheostomies
and tracheostomy education nurses
International Network for Simulation-based Pediatric Innovation, Research and Education

4. Progress since Jan 2013
March 2013IRB
submission
After IRB approval:
July – Dec 2013 :
Phase 1 :retrospective data Phase 2: parent
review
enrollment for simulation
intervention
Jan – June 2014 :
Phase 3: follow up surveys;
and data analysis
• Pilot Project: Approved by IRB June 2013
• Phase 1: complete: Retrospective Review of discharged infants
with tracheostomies
– Submitted abstracts to PAS and SRM
– Manuscript under preparation
• Phase 2: Pilot Project for 10 patients at Texas Children’s Hospital
• Recruitment phase: 6 patients since August 2013
• Phase 3: Prospective follow up post discharge
International Network for Simulation-based Pediatric Innovation, Research and Education

5. Needs / Challenges
1.
Invite and incorporate other centers
2.
Recruitment
3.
Brainstorm other outcomes and data
collection options
1.
Self efficacy: Pre and post survey
1.
Preliminary data on 6 patients: Parents
rate themselves high
2.
Difference: providing CPR, assessing
respiratory rate and trouble shooting
ventilator
3.
No difference: suctioning, changing tube,
assessing color, trouble breathing
2.
Video review
3.
Any other outcome measures?
International Network for Simulation-based Pediatric Innovation, Research and Education

6. How can INSPIRE help?
1.
@ IMSH 2014:
Share and brainstorm with colleagues a proposal for multicenter
project
2.
In 3 months:
Online support for sharing & collaboration amongst centers
participating in multicenter project
3.
Over 1 year:
Aid with data analysis and feedback on project progress
International Network for Simulation-based Pediatric Innovation, Research and Education

7. Contact Information
Shilpa Hundalani
Jennifer Arnold
Institution: Baylor College of medicine
E-mail: jlarnold@bcm.edu;
hundalan@bcm.edu
Phone:832-824-1480
Website / QR Code
www.texaschildrens.org
International Network for Simulation-based Pediatric Innovation, Research and Education