No abstract

Background: Endotracheal suctioning is a vital procedure performed by intensive care nurses to maintain airway patency and optimal gas exchange in critically ill patients under mechanical ventilation. As the procedure can cause several complications, intensive care nurses should have adequate evidence-based knowledge on how to perform the procedure. Aims: This study aimed at examining intensive care nurses' knowledge and experience of the closed suctioning system. This study was a prospective, cross-sectional, descriptive, and multi-centered study conducted with 195 nurses working in the tertiary intensive care units in five Turkish hospitals. Subjects and Methods: The data were collected with a questionnaire developed by the researchers in light of the literature. The data were evaluated with Kruskal–Wallis and Mann–Whitney U tests. Results: The mean age of the nurses was 30.58 ± 6.28 years. The mean knowledge score of the nurses for the closed system was 27.35 ± 12.05 (range = 0–80) and 80.5% of them obtained scores ranging between 0 and 40. Also, 71.8% stated that they did not have any difficulty performing suctioning with the closed system catheter, and 85% said that they saved time with the closed system. However, 50.8% of the nurses said they were not able to suction viscous and sticky secretions efficiently, 44.6% stated they did not need to irrigate the inside of the catheter, and 45.1% of them were undecided whether the coude tip catheter led to hemorrhagic secretion more than straight tip catheter. Conclusions: Almost one-fifth of the nurses had good scores on evidence-based knowledge of suctioning. Most of the nurses' experiences regarding the use and manipulation of the closed system were positive. However, almost half of the nurses pointed out that the closed system was not effective enough to suction viscous and sticky secretions. Regular in-service training sessions may help to improve nurses' current knowledge and experiences.

No abstract

No abstract

Aim: To determine the compliance with nursing drug administration procedure steps associated with access to the central venous catheter for bolus infusion in intensive care units. Methods: This observational study was conducted with 30 nurses working in an intensive care unit of a university hospital. The drug administrations practiced by nurses via central venous catheter were monitored simultaneously at 12:00 a.m., 02:00 p.m., and 06:00 p.m. by two observers. The data were collected using a data collection form and central venous catheter drug administration procedure steps. Results: A total of 90 different drug administrations were observed in three different treatment hours from 30 nurses. The interobserver conformity was found to be moderate in two steps (kappa = 0.520–0.627, P = 0.01) and perfect in all other steps (kappa = 0.821–1.000, P = 0.000). According to the drug administration procedure steps via a central venous catheter, all nurses applied the following steps correctly during all treatment hours: drug card control, preparation of treatment materials, checking the patient’s identity, and steps of drug treatment administration. The following tasks were frequently performed incorrectly or not at all: hand hygiene (before treatment 87.8%; after treatment 82.2%), scrubbing the three-way stopcock entrance with an alcohol swab (55.6%), waiting for the alcohol to dry (81.1%), and flushing the lumen with a compatible fluid (before treatment 84.4%: after treatment 75.6%). Conclusion: Observation of drug administration procedure steps via central venous catheter according to the treatment hours showed that the nurses performed many incomplete or inaccurate drug administration procedure steps and the mistakes increased toward the evening hours.