Endotracheal suctioning in the Intensive Care Unit : an observational study of nurses' practice

Abstract

The aim of this research project was to examine the technique, adopted by qualified nurses working in the ITU of a large general hospital, during the performance of endotracheal suctioning on mechanically ventilated patients. It also sought to determine whether closed or open-suctioning is used more commonly, to examine whether nurses assess the need for suctioning before carrying it out and whether the nurses' practice of endotracheal suctioning conform with research-based recommendations. · The study included a convenient sample of ten qualified registered nurses with more than two years experience in ITU. A descriptive non-experimental approach was used, using a non-participant observational method. A checklist was used to collect data. The results suggested that local nurses employ correct techniques which conform with research-based recommendations in the way they perform suctioning, such as the length of time suctioning is carried out for and the size of catheter used. The nurses however, do not conform to research-based recommendations with regards to infection control measures, which are an integral part of the suctioning technique, and are especially weak in handwashing. It is therefore recommended that nurses receive further education on those aspects of care where their performance was not satisfactory. Further education is required in the general principles of infection control. Further research is also recommended, including the use of self-report methods (questionnaires or interviews) besides observation, in order to identify the reasons behind the nurses' action, as the present study could only provide possible suggestions. The study is also recommended on a larger scale, and studies including staff with less years of experience and observing the same nurse carrying out the procedure more than once are recommended. Controlled experiments are also recommended to assess whether education has a positive effect on performance.