Adherence of critical care nurses to endotracheal suctioning guidelines: a cross-sectional study

Abstract

Background Endotracheal suctioning (ETS) is one of the most common invasive procedures performed by critical care nurses (CCNs) to remove accumulated pulmonary secretions, ensure airway patency for adequate ventilation and oxygenation as well as prevent atelectasis in intubated patients. Objectives To assess the practice of CCNs in intensive care units (ICUs) before, during, and after performing the ETS procedure and identify factors affecting their practice. Methods A cross-sectional and non-participant observational design was conducted in the ICUs of four hospitals in Hodeida city, Yemen. The data were collected using a 25-item observational checklist in the period from May to August 2019. Results More than half (55%) of CCNs scored undesirable (< 50%) regarding their adherence to ETS practice guidelines while the rest scored moderate (50–75%), with none of showing desirable adherence (> 70%) to the guidelines. There was no significant association between gender, age, education level, or length of experience of CCNs in the ICUs and their practice during performance ETS procedures. However, training (p = 0.010) and receiving information about ETS (p = 0.028) significantly improved the CCNs’ practice. Conclusion Most CCNs at the ICUs of Hodeida hospitals do not adhere to evidence-based practice guidelines when performing ETS procedures, possibly resulting in numerous adverse effects and complications for patients. CCNs receiving information and training show better ETS practice than do their counterparts. Therefore, it is necessary to provide the nursing staff with clear guidelines, continuous education and monitoring to improve their practices.

Factors Involved in Compliance With Nursing Care to Prevent Pneumonia Associated With Mechanical Ventilation

“…The American Association for Respiratory Care (AARC) advised against the use of saline in aspiration of secretions with a level of evidence B. 24 , practice that continues to be carried out in variable frequency in hospitals in Yemen according to what was exposed in the research by Alkubati et al 26 , 2022, and also at the Dr. Raymundo Abarca Alarcón General Hospital.…”

A health systems approach to critical care delivery in low-resource settings: a narrative review

“…Essential equipment and consumables required for critical care delivery have been defined [ 19 ]. Although equipment is available in some hospitals [ 36 ], the infrastructure and expertise for maintenance and repair are frequently lacking as is training for effective use [ 26 ]. For example, a survey across 15 ICUs in Ethiopia found that 80% of units had blood gas analysers but only one had the reagents needed [ 68 ].…”

Education Programs for Invasive Procedures Involving Nurses: A Scoping Review

“…A multicenter observational research in France found that nurses did not follow recommendations for suctioning maneuvers (e.g., proper suction catheter size) [6]. Similarly, a cross-sectional study discovered that many critical care nurses do not follow endotracheal suctioning guidelines [8]. According to questionnaire research, many nurses were ignorant of the suggested method of tracheal suctioning [9].…”