Intensive care nurses’ knowledge and practice on endotracheal suctioning of the intubated patient: A quantitative cross-sectional observational study

Abstract

IntroductionEndotracheal suction (ETS) is a common invasive procedure which is done to keep the airways patent by mechanically removing accumulated pulmonary secretions to all in patients with artificial airways. Many life-threatening complications can occur when the procedure is not performed correctly. Although the evidence-based recommendations regarding ETS are available, many of these have not been observed in nurse’s clinical practice. We assessed the intensive care nurses’ knowledge and practice of ETS to intubated patients in selected hospitals in Dar es Salaam, Tanzania.MethodologyA descriptive cross-sectional study design involving 103 Intensive Care Unit (ICU) nurses in Dar es Salaam city was conducted in 2014. Data were analyzed using SPSS version 20 where descriptive statistics were employed to interpret data.ResultsMajority of ICU nurses (69.9%) knew the indication for the procedure, (77.7%) knew the action to be taken in case of abrupt change in the ECG monitor; however, 80.6% demonstrated undesirable overall knowledge on ETS evidence-based recommendations. Nurses with ICU training (57.3%) significantly demonstrated higher knowledge of ETS than non-trained nurses (P<0.005), while all other factors had no influence.Conclusions and recommendationsMajority of ICU nurses do not have desirable knowledge and skills of ETS, and are currently not following current ETS recommendations. This study has shown that training on ICU skills have positive influence to recommended ETS knowledge. We recommend ICU training, provision of clinical guidelines and adequate support to nurses employed in ICUs. Also, further studies using analytical approach to identify other factors beyond the scope of this study and testing the best approach in fostering adherence to ETS evidence-based recommendations are crucial.

Intensive Care Nurses’ Knowledge and Practice of Evidence-Based Recommendations for Endotracheal Suctioning: A Multisite Cross-Sectional Study in Changsha China

“…The guideline contained 26 key recommendations in three procedural phases and 17 points of care (Hu et al, 2019). We also referred to questionnaires or checklists that have been used to assess ETS knowledge or practice of nurses in other countries such as the US and Australia (Leddy & Wilkinson, 2015;Mwakanyanga, Masika, & Tarimo, 2018;Negro et al, 2014;Rn et al, 2007). The questionnaire involved three domains: 1) demographic data, 2) nurses' awareness of, and 3) adherence to the ETS guideline.…”

“…It revealed that considerable gaps exist between the evidence-based ETS practices and the current clinical practices (Graham & Logan, 2004). In order to bridge the evidence-practice gap, theoretical education or training alone may not be adequate to in uence practice change (Ansari et al, 2012;Heidari & Shahbazi, 2017;Mwakanyanga et al, 2018). Routine training together with individual or group support like post-training follow-up, coaching, using of support documents like unit or hospital-level ETS regulations, web or mobile applications, checklists, reminders, userfriendly pictures, and pocket versions of the guideline could potentially elevate the knowledge level and practical ETS skills of intensive care nurses (McKillop, 2004;Mwakanyanga et al, 2018;Straus, Tetroe, & Graham, 2013).…”

Improving nurses’ knowledge of managing endotracheal tube cuff pressure in intensive care units: A quasi-experimental study

“…Strategies in the form of educational programmes should be implemented to enhance the nurses’ knowledge. This is especially important as previous studies conducted on nurses’ knowledge regarding ETT cuff pressure revealed differences in ICU nurses’ knowledge, leading to varying practices (Abubaker et al 2019 ; Jordan 2011 ; Jordan, Van Rooyen & Venter 2012 ; Mohammed et al 2016 ; Mwakanyanga, Masika & Tarimo 2018 ). A study by Mohammed et al ( 2016 ) showed that an educational programme including discussion groups and formal lectures accompanied by suitable teaching aids, such as handouts, posters, coloured pictures and a programme booklet, improved the knowledge of the nurses regarding ETT cuff pressure.…”

Pengaruh Variasi Tekanan Negatif Suction Endotracheal Tube (ETT) Terhadap Nilai Saturasi Oksigen (SpO2)

“…hemodinamika merupakan suatu pengkajian fisiologis yang penting dalam perawatan pasien -pasien kritis. Hasil penelitian menyebutkan mayoritas perawat ICU (69,9%) tahu indikasi prosedur, (77,7%) tahu tindakan yang harus diambil jika terjadi perubahan mendadak pada monitor EKG 14 .…”