Intensive care nurses’ knowledge about endotracheal suctioning guidelines in one major academic hospitals in Johannesburg

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Background: Critically ill patients in Intensive care units are often placed on mechanical ventilation which requires endotracheal suctioning to promote adequate gaseous exchange and manage any underlying progressive condition. However, endotracheal suctioning has been associated with life-threatening complications and increasing hospital stays. Evidence have suggests that poor practice has detrimental effects without appropriate evidence-based knowledge and adherence to recent evidence-based guidelines. Therefore, this South African study investigated intensive care unit (ICU) nurses’ knowledge and practice of evidencebased guidelines for endotracheal suctioning. Purpose: This study aimed to determine intensive care unit nurses’ knowledge of the American Association of Respiratory Care (AARC, 2010) evidence-based guidelines on the endotracheal suctioning technique in one major hospital in Johannesburg. Setting: The study was conducted in five ICUs which include Trauma ICU, Cardiothoracic ICU, Coronary Care ICU, Neurosurgery ICU and General ICU of one major public sector hospital in Johannesburg. Methods: A non-experimental, descriptive and quantitative design was utilised in this study. The sample size comprised 130 (n = 130) nurse respondents. A non-probability convenience sampling method was utilised and the data was collected using a validated questionnaire (Negro et al., 2014). The Questionnaire lists ten (10) strategical questions with each containing 4 options to select, and the respondents had to select the correct one from the listed options. Descriptive statistics were used to analyse the data. Statistical tests included the Chi-square test of association, and the strength of association was estimated using Cramer V tests. Testing was done on the 5% (p<0.05) was found in three of the ten domains. In addition, It was also revealed that respondents with diploma-level training performed better on average in terms of endotracheal suctioning knowledge than those with degrees (381 vs 178, respectively). Although, the diploma nurses outperformed their counterparts in eight of ten domains, the association in this domain was rather weak. Conclusions: This study concluded that endotracheal suctioning remains a difficult procedure to perform according to guidelines for nurses in these ICUs. Hence it can be concluded that some nursing practices may be outdated and potentially threaten patient safety and the quality of care in these ICUs. This highlighted the need for change in practice to ensure adherence to recommendations of the current clinical guidelines and ensure practice-informed education of ICU nurses
A research report submitted in partial fulfilment of the requirements for the degree of Master of Science in Nursing to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg , 2023
Endotracheal suctioning, Knowledge, Evidence-based practice, Intensive care