Endotracheal suction in intensive care: A point prevalence study of current practice in New Zealand and Australia

Gilder, Eileen; Parke, Rachael; Jull, Andrew

doi:10.1016/j.aucc.2018.03.001

Cited by 16 publications

(21 citation statements)

References 32 publications

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“…ETS can cause pain and distress to the patient (Arroyo‐Novoa et al., ; Puntillo et al., , ). A recent survey of current practice in the unit identified that most nurses (84%) perform ETS at the time of extubation and that this is similar to previously described practice (Gilder, Parke, & Jull, ; Hodd et al. , 2010; Scales & Pilsworth, ).…”

Section: Introductionsupporting

confidence: 66%

“…The evidence base for ETS in the ICU patient population is recognized to be of low quality (Restrepo, ), with ETS having known effects on ventilation (Corley et al., , ) and causing pain and distress for patients (Arroyo‐Novoa et al., ). There remains a divergence between CPGs and what happens in clinical practice (Beuret et al., ; Gilder et al., ; Jansson, Ala‐Kokko, Ylipalosaari, Syrjälä, & Kyngäs, ; Negro et al., ). If the results of this study show that avoiding suction is non‐inferior for this patient cohort then this has significant implications for clinical practice.…”

Section: Resultsmentioning

confidence: 99%

“…CPGs recommend that ETS should be provided “as required” (American Association for Respiratory Care, ); however, there is no specific recommendation to guide practice for patients who are ventilated for short periods of time, that is, ≤24 hr. Although the most common practices at extubation are asking the patient to cough and suctioning the ETT at/during extubation (Dawkins, ; Gilder et al., ; Hodd, Doyle, Carter, Albarran, & Young, ; Scales & Pilswoth, ), ETS at extubation can increase the risk of atelectasis, in turn contributing to hypoxia (Loeckinger et al., ; Paulissian et al., ). There is contradictory evidence about the benefit of a positive pressure breath or recruitment manoeuvres at the time of extubation (Andreu et al., ; Hodd, Doyle, Carter, Albarran, & Young, ; Hodd et al., ; L'Hermite et al., ).…”

Section: Introductionmentioning

confidence: 99%

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Study protocol: A randomized controlled trial assessing the avoidance of endotracheal suction in cardiac surgical patients ventilated for ≤ 12 hr

Gilder

Parke

McGuinness

et al. 2019

Journal of Advanced Nursing

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Aims:To assess the safety and efficacy of avoiding endotracheal suction in postoperative cardiac surgical patients mechanically ventilated for ≤ 12 hr. Design:A prospective, single centre, single blind, non-inferiority, randomized controlled trial evaluating the safety and efficacy of avoiding suction in uncomplicated, postoperative, adult cardiac surgical patients mechanically ventilated for ≤ 12 hr.Methods: Randomization will be performed on return to intensive care (ICU) with allocation to either usual postoperative care including suction or to usual care with no suction (intervention arm). The primary outcome is the ratio of partial pressure of oxygen (PaO 2 ) to fraction of inspired oxygen (FiO 2 ) (P/F) 6 hr after extubation. Pain assessments will be performed before, during and after endotracheal suction (ETS) and the patient experience will be investigated with a brief interview the following day. Ethics approval was received in October 2015.Discussion: Endotracheal suction is performed as part of airway management but has potential complications and there is little robust evidence to guide practice. This study will add to the evidence base about the need and benefit of endotracheal suction in this patient cohort. Impact:As there is currently no published evidence about the safety of avoiding endotracheal suction. This study will provide the first evidence about avoidance of endotracheal suction in patients ventilated for less than 1 day. If non-inferior, the results have the capacity to change nursing practice by avoiding a potentially unnecessary procedure, it will build on the body of knowledge about the patient experience. K E Y W O R D Sairway management, cardiac surgery, endotracheal suction, intensive care, nursing, patient experience, randomized controlled trial, safety

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Section: Introductionsupporting

confidence: 66%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Study protocol: A randomized controlled trial assessing the avoidance of endotracheal suction in cardiac surgical patients ventilated for ≤ 12 hr

Gilder

Parke

McGuinness

et al. 2019

Journal of Advanced Nursing

Self Cite

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“…Studies have shown that a 2 mm change in suction catheter diameter would increase systolic and diastolic pressure, pain, and heart rate [8]. The mean suction pressure is approximately twice that of the standard, and in only 67% of cases, patients receive pre-oxygenation [9]. Unlike usual suctioning, ETT suctioning lessens the risk of airway injury and pain [4].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, nurses' performance in ETT suctioning needs further attention [11]. Nurses require education in examination of patients and following oxygenation guidelines [12,10]. According to studies, there is equality between the knowledge of nurses and nursing students in suctioning [13].…”

Section: Introductionmentioning

confidence: 99%

Effect of Simulation-Based Suction Education on the Knowledge and Performance of Pediatric Intensive Care Unit Nurses

2020

jcr

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Introduction: Nursing interventions have a direct effect on the health and clinical improvement of children. Therefore, nurses should be aware of the risks of endotracheal suctioning and receive continuous education in this field. The present study aimed to investigate the effect of simulation-based suction education on knowledge and performance of pediatric intensive care unit nurses. Methods: In a quasi-experimental study between 2019 and 2020, 33 nurses working in pediatric and neonatal intensive care units were selected as availability samples. First, nurses' performance in suctioning was evaluated by a standard checklist, then, suction education was performed by simulation method. Six months after the education, nurses' performance in standard suctioning was reevaluated and analyzed by SPSS 22 software. Results: The mean score of knowledge and performance after the education (43.99 ± 6.03) was significantly different from before the education (5.58 ± 5.3) (P <0.05). Conclusion:The results showed that nurses' performance in suctioning needs further attention. To improve the clinical performance of nurses, the use of small group education is useful. Therefore, it is suggested that the education courses be delivered to nurses in small group discussions in the form of in-service programs.

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Comparison between different internal cross-sections for pulmonary secretion suction catheters

et al. 2022

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Endotracheal suction in intensive care: A point prevalence study of current practice in New Zealand and Australia

Cited by 16 publications

References 32 publications

Study protocol: A randomized controlled trial assessing the avoidance of endotracheal suction in cardiac surgical patients ventilated for ≤ 12 hr

Study protocol: A randomized controlled trial assessing the avoidance of endotracheal suction in cardiac surgical patients ventilated for ≤ 12 hr

Effect of Simulation-Based Suction Education on the Knowledge and Performance of Pediatric Intensive Care Unit Nurses

Comparison between different internal cross-sections for pulmonary secretion suction catheters

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