Determining standard criteria for endotracheal suctioning in the paediatric intensive care patient: An exploratory study

Abstract

This four-phase mixed method study developed an evidence based ‘‘Endotracheal Suction Assessment Tool’’ (ESAT) as a guide for nurses undertaking ‘‘endotracheal tube’’ (ETT) suction within ‘‘Paediatric Intensive Care’’ (PIC). Phase 1 involved a comprehensive literature review to determine the most commonly used criteria for assessing the need for ETT suction. In Phase 2 an ‘‘Endotracheal Suction Questionnaire’’ (ESQ) was developed to survey experienced PIC nurses in Australia and New Zealand regarding their ETT suction decision making process and validity testing of the ESQ. In Phase 3, the ESQ was administered to target group (n = 104). In Phase 4, the empirical evidence generated from this study, based upon the criteria rated by nurses in this study as being most clinically important and essential during the decision making process, determined the ESAT design. Analyses of quantitative results showed a positive correlation between the perceived frequency of use of a criterion and the appropriateness of the assessment. Where a criterion was used less frequently as a clinical indicator for the requirement for ETT suction, participants had a lower regard for this when rating the criterion as a specific single indicator to perform suction. Findings from qualitative data identified six criteria not previously documented within the literature. Further testing and validation of the tool within the PIC setting will determine the clinical viability of the ESAT

Pediatric Critical Care Nursing Research Priorities—Initiating International Dialogue

“…nurses management of insulin titration and weaning patients from mechanical ventilation. [5][6][7][8] A variety of studies evaluate and support nursing's role in providing improved nutritional support in critically ill children; specifically, time to first feeding and titrating enteral feeding to meet nutritional and caloric needs. [9][10][11] Although it is well-known that critically ill patients require nursing care that intervenes quickly to avert or respond to rapidly deteriorating clinical conditions, there are little data describing this core nursing activity.…”

Knowledge about endotracheal suctioning on the part of intensive care nursing professionals: a descriptive study

“…81.5% of the professionals answered the question relating to this area correctly, indicating good knowledge. This care is very important, since errors in this process may culminate in nosocomial infections (1,3,4,9) . The cuff pressure was the area of greatest difficulty reported by professionals in the management of artificial airways.…”

“…The procedure, however, is not free of risks and complications. Comorbidities such as cardiac and/or respiratory failure, hemodynamic instability, tracheobronchial injury and hypoxemia may be a result of the procedure, especially when performed incorrectly (3) . Therefore, it is imperative that this procedure is performed with professional competence, which means not only having the necessary skills, but also knowledge based on updated scientific evidence, guaranteeing efficiency and the safety of the patient (4) .…”

Evaluation the Gap between Knowledge and Practice in Open System Endo-Tracheal Suctioning among Critical Care Nurses

“…: "Endotracheal suction observational checklist": This tool was developed by the researcher after reviewing the relevant literature (Davies, 2008, Ansari, et al, 2012, Frota, et al, 2014 and according to questionnaire sheet to assess nurses' performance of ETS. The observational check list of ETS also included 28 skills which was concerned about nurses' performance in suctioning in three areas of prior, during and post ETS.…”

“…Tools for Data Collection: Two tools were used to collect the data: Tool (I): "Endotracheal suctioning knowledge 'structured questionnaire" was developed by researcher after reviewing the relevant literature (Davies, 2008, Ansari, et al, 2012, Frota, et al, 2014 to assess the knowledge of CCNs regarding ETS and it consists of two parts:…”