Evaluation of endotracheal-suctioning practices of critical-care nurses – An observational correlation study

Abstract

Background: Endotracheal-suctioning (ETS) is a procedure that may constitute a risk factor for ventilator-associated pneumonia (VAP) by increasing microbial colonization of the lower airway. Unsafe ETS practices have been observed worldwide during recent years. Because of adverse reactions, practioners need to take all necessary precautions to ensure patient safety and a high quality of nursing care. The aim of the present study was to evaluate critical-care nurses' performance in relation to current recommendations in their daily practice prior to, during and post ETS events. Methods:A structured, non-participatory, observational study (n=40) was conducted using a 25-item best-practice information sheet to assess critical-care nurses' ETS practices in a mixed medical-surgical intensive-care unit. Onesample-and independent-samples t-tests were used to compare critical-care nurses' ETS performance against current recommendations within different ICU experience groups.Results: The quality of observed ETS practices was significantly lower than the required quality of care (p<0.001). The most significant discrepancies were observed in ETS practices related to infection-control practices. Conclusion:Critical-care nurses are currently not following current ETS recommendations. Significant discrepancies, which may constitute a risk factor for VAP by increasing microbial colonization of the lower airway, were identified. Unsafe ETS practices may jeopardize patient safety, and thus the quality of nursing care. Educational interventions, clinical guidelines and adequate support need to be provided to critical-care nurses to assess and improve their professional capabilities and current practice. Regular auditing and prompt feedback would be beneficial.

Assessment of knowledge and practices of intensive care unit nurses about endotracheal suctioning for adult patients in Baghdad, Iraq teaching hospitals

“…Infectioncontrol practices (e.g., hand hygiene 72.2%, protection of practioners and patients from secretions as well as adequate disposal of the used catheter 67.7% and gloves100.0%, and maintenance of the sterility of the suction catheter) are crucial elements in the prevention of cross-infections and transmission of pathogens via hands or equipment. 15,16 This result agrees with that of the other researcher who reported that In relation to the use of personal protective equipment (PPE), similarly to what is found in the literature high adherence to the use of gloves was ascertained (92%) as was regular use of the mask and apron (72% and 60%), although there was no adherence to the use of eye protection (0%). Studies have shown that the nurses themselves, in spite of recognizing the importance of the use of PPE, do not use it appropriately when under taking the ETS procedure.…”

Slaugytojų žinios ir įgūdžiai atliekant sekreto išsiurbimą iš tracheostomos vamzdelio

“…Slaugytojas turi turėti pakankamai kompetencijos nuspręsti apie sekreto išsiurbimo iš tracheostomos vamzdelio būtinumą. Užsienio šalyse atlikti tyrimai rodo, kad slaugytojai, atlikdami tracheostomos priežiūrą, ne visada remiasi įrodymais pagrįsta praktika [17][18][19][20][21]. Day T., Iles N., Griffiths P. (2009) teigimu, nepakanka įvertin-ti slaugytojų teorines žinias, nes jos gali prastai atspindėti praktiką [19].…”

“…stebėtų atvejų siurbimo slėgis buvo 80-150 mmHg [21]. Airijoje (2008) atlikto tyrimo metu sekreto siurbimo slėgiai viršijo rekomenduojamus slėgius ir svyravo 230 -450 mmHg [20].…”

Effect of Application of Endotracheal Suction Guidelines on Cardiorespiratory Parameters of Mechanically Ventilated Patients

“…It was a developed tool by the researcher after reviewing the related literature (2,3,10,(21)(22)(23) . It was used to gather data of cardiorespiratory parameters to compare between actual routine method practiced by nurses in ICU and guidelines based method that are restricted to evidenced based recommendations.…”

“…The tool was developed by the researcher based on reviewing the relevant literature (2,3,10,(21)(22)(23) . The tool was reviewed for content validity, by professors in the following fields: critical care nursing, critical care medicine, anaesthesia and medical biostatistics.…”