Iran Journal of Nursing

Introduction
For people hospitalized in intensive care units (ICUs), tracheostomy is often performed due to prolongation of mechanical ventilation, maintenance of airways, and better lung health, which at the same time can cause larynx damage and discomfort of the patient. The quality of health care for these people depends mostly on how nurses provide services. Considering that the final result and the possible complications of tracheostomy are directly related to how the nursing staff provides the care, it can be said that the lack of a comprehensive care plan and training in ICUs has a negative effect on nursing care and can increase nursing errors. Due to the high probability of nursing errors in ICUs, it is necessary to update nursing knowledge to reduce errors, and there is a need for continuous training of nurses in these departments. For this reason, the knowledge of nurses about the function and conditions of tracheostomy and the proper management of patients with mechanical ventilation is of particular importance for providing high quality care. This study aims to evaluate the effect of tracheostomy care training on the performance of nurses working in the ICUs of selected hospitals affiliated to Iran University of Medical Sciences.

Methods
This quasi-experimental study was conducted on 64 nurses working in the ICUs of Rasul Akram (n=32) and Firouzgar (n=32) hospitals in 2021, who were selected based on the inclusion criteria: working in the ICUs of selected hospitals, having a bachelor's degree or higher. The exclusion criterion was not attending the training sessions. Due to the presence of all the selected nurses in the training class, there was no sample loss.
The data collection tool was a tracheostomy patient care evaluation questionnaire. In the end, data analysis was performed in SPSS software, version16 using Kolmogorov-Smirnov test (to evaluate the normality of data distribution), descriptive statistics (frequency, percentage, mean, and standard deviation), to describe the data, and inferential statistics (T-test, and analysis of variance). P<0.05 was considered statistically significant.

Results 
The mean age of nurses was 31.49 years. Most of them were female (70.3%) with a bachelor's degree (90.6%). Their mean overall work experience was 6.74 years and the average work experience in the ICU was 4.92 years. Most of nurses (43.8%) had permanent employment. Most of nurses had rotating shift (89.1%), and had not completed the course of tracheostomy care (93.8%). The results of paired t-test showed a statistically significant difference in the mean performance score of nurses before training (85.87±45.8) and after training (93.3±42.33) (P<0.001).

Conclusion 
Considering that the performance of nurses in caring for patients with tracheostomy is not satisfactory in the ICUs of selected hospitals, educating nurses and providing sufficient facilities based on guidelines and opinions of experts are recommended to improve the quality of services to these patients by nurses in the hospitals.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1399.1159).

Funding
This article was extracted from the master’s thesis of Sara Faramarzian Funded by Iran University of Medical Sciences.

Authors' contributions
Initial draft preparation, funding acquisition, preparing the intervention protocol, data analysis and interpretation, review & editing: Sara Faramarzian; Initial draft preparation, preparing the intervention protocol, data collection, data analysis and interpretation, review & editing: Zahra kashaninia; Initial draft preparation, data interpretation, review & editing: Tahereh Najafi; Initial draft preparation, data analysis and interpretation, review & editing:  Hamid Haghani.

Conflict of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to thank the Deputy for Research of Iran University of Medical Sciences and the Nursing and Midwifery Care Research Center for the financial support and the nurses of Rasul Akram and Firouzgar hospitals who participated in this study for their cooperation.



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