ANA Individual Innovation Award Blog – “You Can Do This”

Becky Cherney, RN

I am a critical care bedside nurse with an idea of how to improve patient care and education for patients and their families.  Being a recipient of the 2021 ANA Individual Innovation Award, I can finally see my vision for training new trach patients, and their caregivers, so they are discharged to home in comfort and with confidence, becoming real.

My innovation journey began after the loss of a patient with a trach. This loss inspired me to want to learn more about tracheostomies and what critical care interventions are required by healthcare professionals in a tracheostomy emergency.  In this exploration, I started to also identify break-down points in how healthcare systems educated patients, and their caregivers, for discharge with a trach.  It became really clear that we needed to do better.

Overworked nurses trying to cram in intensive patient trach training in the last 48 hours prior to discharge was not working, and leaving patients deciding to go to a facility, instead of home, because they just didn’t think they could do all this.  They had neither the education nor the skills practice to take this on at-home with so little preparation.

So, I set out to figure out how to fix this important problem.

I first started with a literature review to identify what was already out there regarding best practices in trach care for adult patients. What I found was not much.  While papers and programs are many for pediatric trach patients, little attention had been focused on training adults in this kind of care.  As part of a Practicing Nurse Evidence-Based Practice Fellowship Program, I took this on as a quality improvement project for my health system, developing a multi-disciplinary collaborative team on my unit to focus on solving this problem. Over the course of one to two years, after many iterations on what the team thought an adult patient education program in trach care might look like, coupled with actual trial and error with patients and their caregivers, TrachTrail™ was born.  I was then able to identify five Practice Champions with the same shared clinical interest to help with the roll-out of the TrachTrail™ program to nurses working at the bedside and involve key stakeholders to promote growth and sustainability of the program in the health system.

However, up to that point, TrachTrail™ had been developed more as a training program for the nurses. I knew I also needed to create easy-to-read and understand materials for patients/caregivers to reference at home.  So, this is where I’m at with this program development—trying to make it patient/caregiver-centric so they can be reinforced in their education and skills once they go home.

Has this all been easy?  Absolutely not.  Trying to be that change agent in a system that needs to clear beds to make room for the next patient, doesn’t easily allow for a two-week patient ed training program to occur. Getting a diverse collaborative of healthcare professionals to agree on best practices, also pretty difficult.  Not having funds to develop your materials—can be a show stopper.  Explaining to colleagues you want to commercialize this when nurses just want to see it “get out there”, also challenging.  And these are just a few (of the many) barriers I faced in the creation of this nursing innovation.

But through all the ups and downs of working to bring this innovation to life, my inspiration has continued to be the patients and their caregivers themselves—that first patient of mine with a trach who passed, and all the others I’ve cared for since.  That, coupled with some incredibly supportive co-workers and unit administration, innovation partners on campus, ANA innovation funding, and more, I can see this dream becoming a reality, and I couldn’t be more excited.  Nursing innovation is critical to healthcare and can be the way of the future if we just let our patients, and their families, lead us. So, hold true to your own innovative spirit and tenacity to make a difference. You can do this!

October 2021