Paediatric Tracheostomy and Respiratory Services Clinical Nurse Consultant at Monash Health.
Research project: Introducing safer and more effective ties to secure tracheostomy tubes when worn by infants and children in hospitals.
Sandy Foster is one of our scholarship recipients of the 2025 Implementation Mentoring Program. This 12-month program supports clinicians, nurses, improvement facilitators, health-service managers and implementation researchers with new evidence-informed learnings and mentorship opportunities that will support the successful implementation of their real-world health service projects.
Can you tell us about yourself and your career journey to date?
I have worked for Monash Health for the past 28 years. Initially I worked on the acute paediatric medical/oncology ward. From 2005 – 2024 I worked with Monash Children’s at Home within the Complex Care Team as a Clinical Nurse Consultant. This role provided and improved service provision for children with complex medical needs and their families at inpatient, outpatient and ambulatory levels. In January 2025, I transitioned into a newly established role as the Clinical Nurse Consultant for Paediatric Tracheostomy and Respiratory Services (PTRS). My focus in this role is to promote and implement evidence-based best practices in the management of children with tracheostomies. This vulnerable patient group is at heightened risk of adverse events related to tracheostomy tube care, and my work is dedicated to improving safety and outcomes for these children.
Tell us about your project including the significance of your project and the healthcare problem it intends to solve?
At Monash Children’s Hospital, cotton ties are currently used to secure tracheostomy tubes in infants and children under six years old. However, this method has been linked to significant pressure injuries around the neck. To reduce skin damage, dressings are placed beneath the ties, but this introduces a safety risk: if a child removes the dressing, the ties may loosen, increasing the likelihood of accidental tracheostomy tube dislodgement. This study aims to implement an alternative securing method—a one-piece padded foam collar—and will examine current practices and complications associated with tracheostomy securing devices across hospitals in Australia and New Zealand. This project seeks to implement improved tracheostomy securement methods that enhance protection against pressure-related injuries without compromising safety.
What does it mean for you and your work to be supported by this 12-month mentoring program?
Implementation science is a very new area for me, and having mentorship throughout this project will be invaluable in building both my confidence and access to the necessary resources. It has been over two decades since I last undertook a research project, and returning to this space feels both exciting and daunting—almost like learning a new language.
What knowledge and skills are you hoping to acquire during the program?
I hope to apply the research knowledge and skills gained through this project to future initiatives, with a strong focus on integrating implementation science into clinical practice. My aim is to ensure that the care provided to infants and children with tracheostomies is guided by evidence-based best practice, and that these guidelines are effectively translated into everyday care to improve safety and outcomes for this vulnerable population.
Why do you think programs like this are important for healthcare practitioners and the healthcare sector?
Programs like this are essential for healthcare practitioners, as research can often feel overwhelming and is therefore sometimes avoided. Historically, opportunities for mentorship in research have been limited, which can discourage participation. I believe that providing structured mentorship throughout the research process would encourage more clinicians to engage with research and implementation science. This support not only makes the process more approachable but also has the potential to significantly boost staff confidence and capability.
What impact can you foresee programs like this having on the healthcare sector and clients who access healthcare services?
I believe that implementing evidence-based practices in healthcare leads to improved outcomes for clients and enhances public trust in the facilities providing care. Continuously evaluating and refining care delivery methods within healthcare settings is essential to ensure quality and effectiveness.
