HomeGrown Solution: Affordable Tracheostomy Skills Trainer
Affordable Tracheostomy Skills Trainer
Margaret DeYoung, MS, RN, CNS
HomeGrown Solution Number
Identification of the Problem
During the early days of the Covid-19 pandemic, many nursing programs were tasked with adapting curriculum to remote formats. Though didactic course content could be delivered remotely with success, hands-on skills training sessions were difficult to replicate at a distance. Access to affordable models on which students could remotely practice nursing skills was identified as essential when uncertainty prevailed in regard to resumption of in-person clinical skills labs.
I researched the availability of affordable tracheostomy skills trainers that could be purchased in quantity so students could practice basic tracheostomy skills remotely, either with direction from faculty via an online platform, or while following along with an instructional video or an acceptable skills checklist. I was unable to locate any tracheostomy models that were less than $700, a price that was completely cost-prohibitive. As a simulationist, I imagined that a low-cost device could be created to house a tracheostomy tube in a manner that could provide adequate realism to support the students' practice of relevant tracheostomy skills remotely. They could record themselves performing the skills and the recording could be uploaded to the faculty. Or the devices could be used in a classroom or skills lab while all students could practice simultaneously, rather than waiting for one trainer to become available.
- Create a cost-effective tracheostomy skills trainer for nursing students to practice changing the dressing and securement devices, and suctioning
- Create the described device in such a manner that it is also durable, easy to clean, and portable
- High-density foam roller (used for physical therapy, yoga, or stretching), 6-inch diameter. These come in various lengths and I have utilized both the 36-inch and 48-inch varieties (Amazon), cutting them into 6-inch sections. The texture is firm, but not brittle. One 6-inch section makes one skills trainer with a simulated neck diameter of about 19 inches. One could consider using smaller diameter foam rollers to simulate pediatric tracheostomy skills.
- Tracheostomy tube for each trainer to be created. When I was purchasing the tracheostomy tubes, availability of many models was very limited due to the pandemic. I was able to locate a large quantity of tracheostomy tubes (Shiley size 10) with an inner diameter of 8.9mm and an outer diameter of 13.8mm and proceeded with that tracheostomy tube for the trainers for an adult-sized model. Different sizes of tracheostomy tubes could be accommodated on these trainers by adjusting the sizes of holes made in the foam roller sections.
- Tracheostomy ties or other securement device for each trainer. The tracheostomy tubes I purchased came with ties and I purchased an additional securement device for each so that students could practice changing both.
- 6-dram prescription pill bottle (optional) for each trainer
- Split sponges or 4x 4s
- Tracheostomy suctioning kits (for skills practice)
- Tracheostomy dressing change kits (for skills practice)
Steps to Creating the Solution
- Cut the foam roller(s) into 6-inch sections using either a hand saw or electric knife.
- With a permanent marker or pen, make a mark on one flat end of a section of foam roller that is 1 1/2 inches from its outside curved surface. This will be the bottom of the trainer.
- Drill a 3/4-inch hole about 4 inches straight into the foam roller at the mark you made. The opposite surface that will be the top of the trainer needs to stay intact.
- Next, you need to prepare to make a hole on the outer curved side of the foam roller that serves as the 'neck' to accommodate the curved shape of the tracheostomy tube you will be inserting. To this end, make a mark on the outer side of the foam roller about 2 inches down from the intact top surface as you visualize it connecting downward with the first hole you made.
- Drill a 3/4-inch hole into your mark at a downward angle until it meets the other hole you made previously, about 1 1/2 inches deep. You are aiming the drill bit towards the bottom of the trainer at an angle that will accommodate the curved shape of the tracheostomy tube.
- Using your fingers, clear the foam debris out of both holes and smooth the interior surfaces.
- Carefully manipulate the tracheostomy tube into the hole on the curved side of the model.
- Attach the dressing and ties/securement device to complete the trainer.