The Low Frequency of High-Frequency Ventilation in Transport: Implementation of a training program for a high-risk low-frequency procedure

By Charles Hood, RN, CFRN

Background

High Frequency Ventilation (HFV) is often used in critically ill patients with hypoxic/hypercarbic respiratory failure as a salvage maneuver or a bridge to initiation of Extra Corporeal Life Support.  Many patients will not survive transport without the availability of HFV and a clinician skilled in operating the ventilator.  Transport of these patients require all Critical Care Transport RN’s be trained in HFV. 

PICO Question

This project focused on determining if the implementation of a multifaceted training program would affect competency of clinicians utilizing High Frequency Percussive Ventilation during transport.  The goal was to train transport team members to competently and safely transport patients requiring HFV. 

Methods

Compiled existing and created training materials for the transport team. Multifaceted training materials included:  written didactic material, live/video presentation, videos, and in situ simulation.  Adult learning principles were utilized including a reversed classroom, micro learning.  Table top scenarios and 1:1 coaching were also used over a 4 week period ending in a full immersive simulation of a patient requiring HFV.  Pre and post training data was completed to assess teams’ objective and self-perceived competency. 

Results

A significant increase in both self-perceived competency and objective competency was demonstrated in the post training surveys.   A 29% increase in correct answers in the objective survey was demonstrated post training which further increased by 36% post post survey.   

Discussion

Individual team members also expressed increased confidence in their ability to perform a HFV transport.  Post training 3 successful HFV transports have been completed.

Implications/Conclusion

Multifaceted training for high risk/low volume procedures appears to improve clinician’s competency and could be utilized for other critical procedures.  Quarterly refresher training will need to be instituted to maintain competency.