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Öğe Effect of standardized hands-on-training in caregivers of children with tracheostomy(European Respiratory Society Journals Ltd, 2021) Yılmaz Yeğit, Cansu; Ayzıt Kılınç, Ayşe; Guliyeva, Aynur; Atağ, Emine; Yazan, Hakan; Can Oksay, Sinem; Köstereli, Ebru; Uzuner, Selçuk; Onay, Zeynep Reyhan; Hepkaya, Evrim; Ergenekon, Almala Pınar; Kalyoncu, Mine; Ünal, Füsun; Mavi, Deniz; Ayhan, Yetkin; Çollak, Abdülhamit; Cenk, Mürüvvet; Arslan, Hüseyin; Başkan, Azer Kılıç; Bilgin, Gülay; Baş İkizoğlu, Nilay; Ay, Pınar; Öktem, Sedat; Gökdemir, Yasemin; Uyan, Zeynep Seda; Çakır, Erkan; Girit, Saniye; Çokuğraş, Haluk; Karadağ, Bülent; Karakoç, Fazilet; Eralp, Ela ErdemIntroduction: The pediatric tracheostomy related mortality mostly occurs due to accidental decannulation and cannula obstruction. The caregivers may be discharged with inadequate knowledge. Aims and objectives: Simulation training can highlight skills regarding tracheostomy care. Our aim is to investigate if a standardized hands-on-training improves knowledge and skills among caregivers. Methods: Before the traning, we applied a pretest to caregivers in order to assess their knowledge and current practises. Skills were evaluated by two simulation scenarios in a patient model: cannula change and aspiration. After one hour theoretical and practical hands-on training, the same post-test was applied, skills were reevaluated regarding cannula change and aspiration with practical tests. Results: The multicenter study included 65 caregivers of patients with tracheostomy. The median score of the theoretical test including 23 questions improved from 12 to 18 (p<0.001). The specific knowledge questions that were considered critical for tracheostomy care including minimum number of aspiration per day, required frequency of tracheostomy cannula change, solutions recommended for tracheostomy skin care, the pressure for the aspiration, mean duration of aspiration and the depth of aspiration also improved significantly after the education (p<0.001 for all of the specific questions). There was a significant improvement in both cannula change and aspiration skills regarding median scores of correct steps in procedures (p<0.001). Conclusions: A standardized hands-on training is highly effective to increase the rate of proper practices for tracheostomy care and should be implemented for all centers.Öğe Efficacy of standardized tracheostomy training with a simulation model for healthcare providers: A study by ISPAT team(Wiley, 2022) Uyan, Zeynep Seda; Atağ, Emine; Ergenekon, Almala Pınar; Gökdemir, Yasemin; Gökler, Ozan; Ay, Pınar; Baş İkizoğlu, Nilay; Cenk, Mürüvvet; Erdem Eralp, Ela; Sivrikaya, Ulufer; Girit, Saniye; Çakır, Erkan; Kılıç, Ayşe; Yazan, Hakan; Can Oksay, Sinem; Hepkaya, Evrim; Kıyan, Gürsu; Karadağ, Bülent; Karakoç, Fazilet; Öktem, SedatIntroduction Tracheostomy care in children may be challenging, due to lack of knowledge of healthcare providers (HCPs). The aim of this study was to determine the level of knowledge of HCP who follow patients with tracheostomy and to increase this level with theoretical training and training in a simulation laboratory. Materials and Methods ISPAT (IStanbul PAediatric Tracheostomy), a multidisciplinary team for tracheostomy care was established and a training program was prepared. Participants were subjected to theoretical and practical pretests which evaluated their knowledge levels and skills for care, follow-up, and treatment of a patient with tracheostomy. After the theoretical and practical training given to the participants with a simulation model, theoretical and practical posttests were applied. Results Fifty-one HCP from nine tertiary pediatric clinics in Istanbul were enrolled in the training program. Only six (11.8%) of them had received standardized training programs previously. Regarding the theoretical tests, seven of the 33 questions were indicated as essential. The knowledge level of the participants based on the essential questions significantly increased after the training (p < 0.05 for all of the essential questions). The total number of correct answers and correct answers of three subheadings also significantly increased after the practical training (p < 0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent in general. Conclusion Training in a simulation laboratory in combination with theoretical education can improve the knowledge and skills of the HCP enabling improved care of children with a tracheostomy.Öğe Home mechanical ventilation in children: The experience of pediatric pulmonology divisions in Istanbul(European Respiratory Society Journals Ltd, 2022) Yanaz, Mürüvvet; Ünal, Füsun; Hepkaya, Evrim; Yazan, H.; Oksay, S. Can; Köstereli, Ebru; Yeğit, C. Yılmaz; Başkan, A. Kılıç; Onay, Z. R.; Gülieva, Aynur; Soyyiğit, Aslınur; Kalyoncu, M.; Küçük, Hanife Büşra; Ergenekon, Almala Pınar; Atağ, Emine; Uzuner, Selçuk; Baş İkizoğlu, Nilay; Kılınç, Ayşe Ayzıt; Ay, P.; Eralp, E. Erdem; Gökdemir, Yasemin; Öktem, Sedat; Çakır, Erkan; Girit, Saniye; Uyan, Zeynep Seda; Cokuğraş, Haluk; Ersu, Refika; Karadağ, Bülent; Karakoç, Feyza[Abstract Not Available]Öğe Immunomodulator effect of topical zinc oxide application in tuberculin skin test(Kare Publisher, 2018) Nuhoğlu, Çağatay; Hepkaya, Evrim; Önal, Zehra Esra; Akıcı, Narin; Gürbüz, Tamay; Atasayan, Vildan; Ceran, ÖmerOBJECTIVE: We aimed to evaluate the sensitivity of tuberculin skintest (purified protein derivative-PPD) by topical zinc application on test site to improve diagnostic reliability. METHODS: We performed this study in 100 children aged 6-14 years, and plasma zinc levels were analyzed after 10-12 hours fasting. After PPD, we applied 40% zinc oxide cream on one forearm and placebo on the other forearm. PPD indurations were measured 72 hours later. RESULTS: In this study, 26% of the children showed increases in PPD induration following local zinc applications. There was no correlation between indurations size and serum zinc levels. CONCLUSION: We concluded that topical zinc cream application can enhance sensitivity of tuberculin reactivityin the diagnosis of tuberculosis.Öğe The effect of training the health care providers with simulation model on the care of patients with chronic tracheostomy(European Respiratory Society Journals Ltd, 2021) Uyan, Zeynep Seda; Atağ, Emine; Ergenekon, Almala Pınar; Gökdemir, Yasemin; Gökler, Ozan; Ay, Pınar; Baş İkizoğlu, Nilay; Cenk, Mürüvvet; Erdem Eralp, Ela; Sivrikaya, Ulufer; Girit, Saniye; Çakır, Erkan; Ayzıt Kılıç, Ayşe; Yazan, Hakan; Can Oksay, Sinem; Hepkaya, Evrim; Karadağ, Bülent; Karakoç, Fazilet; Öktem, SedatIntroduction: Tracheostomy care in children may be challenging, due to lack of knowledge of health care providers. The aim of this study was to determine the level of knowledge of health care providers who follow patients with tracheostomy and to increase this level with theoretical education and training in a simulation laboratory. Materials and Methods: Volunteer participants were subjected to a theoretical pretest which evaluated their knowledge level for the care, follow-up and treatment of patients with tracheostomy. Then, practical testing with three subheadings evaluating the change of the tracheostomy cannula was applied. After theoretical training and one-on-one practical training given to the participants with a simulation model, theoretical and practical posttests were applied. Results: Fifty-one health care providers from six tertiary pediatric clinics in Istanbul were enrolled in the educational course. Only 6 (11.8%) of them received standardised training programme previously. Regarding the theoretical tests, seven of the 33 questions were indicated as crucial. The knowledge level of the participants based on the crucial questions significantly increased after the training (p value <0.05 for all of the crucial questions). Total number of correct answers and correct answers of 3 subheadings also significantly increased after the practical training (p value <0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent. Conclusion: Training in simulation laboratory together with theoratical education can improve the knowledge and skills of the health care providers enabling improved care of children with tracheostomy.
