There is an overuse of oral antibiotics and acute care visits conducted to treat children with uncomplicated tympanostomy tube otorrhea (TTO), a condition easily identified by the child’s caregiver who can then independently initiate treatment with ototopical antibiotic drops (TAD). Yet, some caregivers seek urgent medical attention for children with TTO, which often results in mismanagement of the condition including the administration of oral antibiotics. This quality improvement initiative involved the development and implementation of an educational program for caregivers of children with tympanostomy tubes (TT). Resources for caregivers included a web-based instructional video, informational pocket-card, and a post-operative text reminder to educate, empower and improve the self-efficacy of caregivers of children with TTO to initiate treatment independently when clinically indicated. Fifty-eight caregivers were enrolled. Caregiver self-efficacy mean scores were analyzed (paired T-test) and significantly higher (p=<0.0001) after implementing the educational program when compared to pre-intervention scores on all 7 self-efficacy items measured. Caregivers were surveyed regarding their perception of the educational program, and the majority felt the resources were helpful and valuable for future use. Twenty-one percent of the patients experienced post-operative TTO; 100% of those caregivers reported initiating TAD, 58% of whom referred to the educational resources. Those who did not refer to the educational material all had children who had previous TTs. No children received oral antibiotics following tube placement related to TTO. Recommendations pertaining to scaling, sustainability and dissemination of the project are also presented.
","abstract_html":"<p>There is an overuse of oral antibiotics and acute care visits conducted to treat children with uncomplicated tympanostomy tube otorrhea (TTO), a condition easily identified by the child’s caregiver who can then independently initiate treatment with ototopical antibiotic drops (TAD). Yet, some caregivers seek urgent medical attention for children with TTO, which often results in mismanagement of the condition including the administration of oral antibiotics. This quality improvement initiative involved the development and implementation of an educational program for caregivers of children with tympanostomy tubes (TT). Resources for caregivers included a web-based instructional video, informational pocket-card, and a post-operative text reminder to educate, empower and improve the self-efficacy of caregivers of children with TTO to initiate treatment independently when clinically indicated. Fifty-eight caregivers were enrolled. Caregiver self-efficacy mean scores were analyzed (paired T-test) and significantly higher (p=<0.0001) after implementing the educational program when compared to pre-intervention scores on all 7 self-efficacy items measured. Caregivers were surveyed regarding their perception of the educational program, and the majority felt the resources were helpful and valuable for future use. Twenty-one percent of the patients experienced post-operative TTO; 100% of those caregivers reported initiating TAD, 58% of whom referred to the educational resources. Those who did not refer to the educational material all had children who had previous TTs. No children received oral antibiotics following tube placement related to TTO. Recommendations pertaining to scaling, sustainability and dissemination of the project are also presented.</p>","abstract_has_math":false,"creators":["Mackey, Wendy Lord"],"institution":null,"degree_name":"Doctor of Nursing Practice (DNP)","degree_level":"Open Access Thesis","degree_discipline":"Yale University School of Nursing","degree_department":null,"school":null,"contributors":["Martha K. Swartz"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2022,"date_issued":"2022-01-01T08:00:00Z","date_published":"2022-01-01T08:00:00Z","updated_at":"2026-07-24T06:16:14Z","subjects":["antibiotic stewardship, otolaryngology, otorrhea, pediatric, tympanostomy tube, web-based education"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://elischolar.library.yale.edu/ysndt/1136","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Martha K. Swartz"]},{"key":"dc:creator","label":"Author","values":["Mackey, Wendy Lord"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Yale University School of Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Open Access Thesis"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Nursing Practice (DNP)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["antibiotic stewardship, otolaryngology, otorrhea, pediatric, tympanostomy tube, web-based education"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://elischolar.library.yale.edu/ysndt/1136"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["There is an overuse of oral antibiotics and acute care visits conducted to treat children with uncomplicated tympanostomy tube otorrhea (TTO), a condition easily identified by the child’s caregiver who can then independently initiate treatment with ototopical antibiotic drops (TAD). Yet, some caregivers seek urgent medical attention for children with TTO, which often results in mismanagement of the condition including the administration of oral antibiotics. This quality improvement initiative involved the development and implementation of an educational program for caregivers of children with tympanostomy tubes (TT). Resources for caregivers included a web-based instructional video, informational pocket-card, and a post-operative text reminder to educate, empower and improve the self-efficacy of caregivers of children with TTO to initiate treatment independently when clinically indicated. Fifty-eight caregivers were enrolled. Caregiver self-efficacy mean scores were analyzed (paired T-test) and significantly higher (p=<0.0001) after implementing the educational program when compared to pre-intervention scores on all 7 self-efficacy items measured. Caregivers were surveyed regarding their perception of the educational program, and the majority felt the resources were helpful and valuable for future use. Twenty-one percent of the patients experienced post-operative TTO; 100% of those caregivers reported initiating TAD, 58% of whom referred to the educational resources. Those who did not refer to the educational material all had children who had previous TTs. No children received oral antibiotics following tube placement related to TTO. Recommendations pertaining to scaling, sustainability and dissemination of the project are also presented.
"]},{"key":"dc:title","label":"Title","values":["Educational Program For Caregivers Of Children With Tympanostomy Tube Otorrhea: Impact On Caregiver Self-Efficacy And Clinical Outcomes"]}]}],"canonical_facts":{"dc:contributor":["Martha K. Swartz"],"dc:creator":["Mackey, Wendy Lord"],"dc:description.abstract":["There is an overuse of oral antibiotics and acute care visits conducted to treat children with uncomplicated tympanostomy tube otorrhea (TTO), a condition easily identified by the child’s caregiver who can then independently initiate treatment with ototopical antibiotic drops (TAD). Yet, some caregivers seek urgent medical attention for children with TTO, which often results in mismanagement of the condition including the administration of oral antibiotics. This quality improvement initiative involved the development and implementation of an educational program for caregivers of children with tympanostomy tubes (TT). Resources for caregivers included a web-based instructional video, informational pocket-card, and a post-operative text reminder to educate, empower and improve the self-efficacy of caregivers of children with TTO to initiate treatment independently when clinically indicated. Fifty-eight caregivers were enrolled. Caregiver self-efficacy mean scores were analyzed (paired T-test) and significantly higher (p=<0.0001) after implementing the educational program when compared to pre-intervention scores on all 7 self-efficacy items measured. Caregivers were surveyed regarding their perception of the educational program, and the majority felt the resources were helpful and valuable for future use. Twenty-one percent of the patients experienced post-operative TTO; 100% of those caregivers reported initiating TAD, 58% of whom referred to the educational resources. Those who did not refer to the educational material all had children who had previous TTs. No children received oral antibiotics following tube placement related to TTO. Recommendations pertaining to scaling, sustainability and dissemination of the project are also presented.
"],"dc:identifier":["https://elischolar.library.yale.edu/ysndt/1136"],"dc:subject":["antibiotic stewardship, otolaryngology, otorrhea, pediatric, tympanostomy tube, web-based education"],"dc:title":["Educational Program For Caregivers Of Children With Tympanostomy Tube Otorrhea: Impact On Caregiver Self-Efficacy And Clinical Outcomes"],"thesis:degree_discipline":["Yale University School of Nursing"],"thesis:degree_level":["Open Access Thesis"],"thesis:degree_name":["Doctor of Nursing Practice (DNP)"]},"updated_at":"2026-07-24T06:16:14Z"}