Title: Are the intensive care nurses practicing correctly for patients with endotracheal tubes ? Results from National Hospital Colombo.

Biography:

Colombage T.D is  Senior Lecturer at National Hospital of Sri Lanka. Her research interest is nursing practices.  

Abstract

Endotracheal intubation and mechanical ventilation are essential life saving treatment for many critically ill patients. Artificial air way is utilized to facilitate mechanical ventilation and the endotracheal tube (ETT) is commonly used. Endotracheal suctioning (ETS) is one common procedures performed in patients with artificial airways. It is a component of bronchial hygiene therapy. Aim of this study is to describe reported practices among intensive care unit (ICU) for monitoring endotracheal tube and related issues and to assess the current practices of suctioning endotracheal tubes in ICU of National Hospital of Sri Lanka (NHSL) A cross sectional hospital based study was done among nurses in all ICUs of NHSL. Self administered questionnaire was developed using American Association of Respiratory Care (AARC) clinical Practice guideline 2010. Data was analyzed by using SPSS 16 version. Majority of nurses were females and aged between 20- 40 years (91.3%). Reported correct practices was 57.8% (N= 107). Most had good reported practices (> 75%) on VAP bundle to prevent ventilator associated infection in ICU, clamp the suction catheter when entering it to the ET tube for suctioning, How long do you keep the patient in 100% oxygen after the ET suction. Only 18% had practiced proper oral hygiene in mechanically ventilated patients. Majority (63,2%) reported incorrect practices related to suction method and measuring the suction catheter length. Almost half (55.7%) responded that they administer oxygen prior to the suctioning, during suctioning and post of suctioning. Only 21.6% responded they do pre oxygenation only and 47% responded they had practiced auscultation prior and post suction. Only 5.4% responded they auscultate lung sounds prior, during and post suctioning. Most were not following current recommendations of AARC clinical practice Guideline. It is recommended to develop correct protocols and guidelines for ET suctioning and mechanically ventilated patients.

Key words ET intubation ,practices, ICU nurses, mechanical ventilation