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

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 (PConclusions 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.引言 气管内吸痰术（Endotracheal suction, ETS）是一种常见侵入性操作，通过机械清除人工气道患者体内积聚的肺部分泌物以维持气道通畅。若操作不当，可能引发多种危及生命的并发症。尽管已有针对该术式的循证推荐，但诸多推荐在临床护理实践中并未得到落实。本研究针对坦桑尼亚达累斯萨拉姆地区部分医院的重症监护室（Intensive Care Unit, ICU）护士对插管患者实施气管内吸痰术的知识掌握与实践现状展开评估。 研究方法 本研究于2014年开展，采用描述性横断面研究设计，共纳入达累斯萨拉姆市的103名ICU护士。研究数据采用SPSS 20.0版本进行分析，运用描述性统计学方法解读所得数据。 研究结果 多数ICU护士（69.9%）知晓该操作的适应证，77.7%能够正确应对心电监护仪（ECG monitor）出现的突发异常，但80.6%的护士对气管内吸痰术的循证推荐整体掌握情况欠佳。接受过ICU专项培训的护士（57.3%）在该术式相关知识掌握程度上显著优于未接受培训的护士（原文此处疑似缺失P值相关内容）。 结论与建议 多数ICU护士尚未具备合格的气管内吸痰术相关知识与技能，且未遵循现行的术式循证推荐规范。本研究证实，ICU技能培训对提升护士的气管内吸痰术循证知识掌握水平具有积极影响。建议针对ICU护士开展专项培训、提供临床操作指南并给予充足的支持保障。此外，开展分析性研究以识别本研究未涵盖的其他影响因素，并探索提升护士遵循气管内吸痰术循证推荐依从性的最优方案，同样具有重要意义。