A multisite survey of suctioning techniques and airway management practices

Mary Lou Sole, Jacqueline F. Byers, Jeffery E. Ludy, Ying Zhang, Christine M. Banta, Kathy Brummel

Research output: Contribution to journalReview article

81 Citations (Scopus)

Abstract

• BACKGROUND: Ventilator-associated pneumonia, common in critically ill patients, is associated with microaspiration of oropharyngeal secretions and may be related to suctioning and airway management practices. • OBJECTIVES: To describe institutional policies and procedures related to closed-system suctioning and airway management of intubated patients, and to compare practices of registered nurses and respiratory therapists. • METHODS: A descriptive, comparative, multisite study of facilities that use closed-system suctioning devices on most intubated adults was conducted. Nurses and respiratory therapists who worked at the sites completed surveys related to their practices. • RESULTS: A total of 1665 nurses and respiratory therapists at 27 sites throughout the United States responded. The typical respondent had at least 6 years' experience with patients receiving mechanical ventilation (61%) and a baccalaureate degree or higher (54%). Most sites had policies for management of endotracheal tube cuffs (93%), hyperoxygenation (89%) and use of gloves (70%) with closed-system suctioning, and instillation of isotonic sodium chloride solution for thick secretions (74%). Only 48% of policies addressed oral care and 37% addressed oral suctioning. Nurses did more oral suctioning and oral care than respiratory therapists did, and respiratory therapists instilled sodium chloride solution more and rinsed the suctioning device more often than nurses did. • CONCLUSIONS: Policies vary widely and do not always reflect current research. Consistent performance of practices such as wearing gloves for airway management and maintaining endotracheal cuff pressures must be evaluated. Collaborative, research-based policies and procedures must be developed and implemented to ensure best practices for intubated patients.

Original languageEnglish (US)
Pages (from-to)220-230
Number of pages11
JournalAmerican Journal of Critical Care
Volume12
Issue number3
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Airway Management
Nurses
Sodium Chloride
Organizational Policy
Ventilator-Associated Pneumonia
Equipment and Supplies
Practice Guidelines
Artificial Respiration
Research
Critical Illness
Surveys and Questionnaires
Pressure

ASJC Scopus subject areas

  • Critical Care

Cite this

Sole, M. L., Byers, J. F., Ludy, J. E., Zhang, Y., Banta, C. M., & Brummel, K. (2003). A multisite survey of suctioning techniques and airway management practices. American Journal of Critical Care, 12(3), 220-230.

A multisite survey of suctioning techniques and airway management practices. / Sole, Mary Lou; Byers, Jacqueline F.; Ludy, Jeffery E.; Zhang, Ying; Banta, Christine M.; Brummel, Kathy.

In: American Journal of Critical Care, Vol. 12, No. 3, 01.05.2003, p. 220-230.

Research output: Contribution to journalReview article

Sole, ML, Byers, JF, Ludy, JE, Zhang, Y, Banta, CM & Brummel, K 2003, 'A multisite survey of suctioning techniques and airway management practices', American Journal of Critical Care, vol. 12, no. 3, pp. 220-230.
Sole ML, Byers JF, Ludy JE, Zhang Y, Banta CM, Brummel K. A multisite survey of suctioning techniques and airway management practices. American Journal of Critical Care. 2003 May 1;12(3):220-230.
Sole, Mary Lou ; Byers, Jacqueline F. ; Ludy, Jeffery E. ; Zhang, Ying ; Banta, Christine M. ; Brummel, Kathy. / A multisite survey of suctioning techniques and airway management practices. In: American Journal of Critical Care. 2003 ; Vol. 12, No. 3. pp. 220-230.
@article{e10cf95a6a424633b063d3407dab1022,
title = "A multisite survey of suctioning techniques and airway management practices",
abstract = "• BACKGROUND: Ventilator-associated pneumonia, common in critically ill patients, is associated with microaspiration of oropharyngeal secretions and may be related to suctioning and airway management practices. • OBJECTIVES: To describe institutional policies and procedures related to closed-system suctioning and airway management of intubated patients, and to compare practices of registered nurses and respiratory therapists. • METHODS: A descriptive, comparative, multisite study of facilities that use closed-system suctioning devices on most intubated adults was conducted. Nurses and respiratory therapists who worked at the sites completed surveys related to their practices. • RESULTS: A total of 1665 nurses and respiratory therapists at 27 sites throughout the United States responded. The typical respondent had at least 6 years' experience with patients receiving mechanical ventilation (61{\%}) and a baccalaureate degree or higher (54{\%}). Most sites had policies for management of endotracheal tube cuffs (93{\%}), hyperoxygenation (89{\%}) and use of gloves (70{\%}) with closed-system suctioning, and instillation of isotonic sodium chloride solution for thick secretions (74{\%}). Only 48{\%} of policies addressed oral care and 37{\%} addressed oral suctioning. Nurses did more oral suctioning and oral care than respiratory therapists did, and respiratory therapists instilled sodium chloride solution more and rinsed the suctioning device more often than nurses did. • CONCLUSIONS: Policies vary widely and do not always reflect current research. Consistent performance of practices such as wearing gloves for airway management and maintaining endotracheal cuff pressures must be evaluated. Collaborative, research-based policies and procedures must be developed and implemented to ensure best practices for intubated patients.",
author = "Sole, {Mary Lou} and Byers, {Jacqueline F.} and Ludy, {Jeffery E.} and Ying Zhang and Banta, {Christine M.} and Kathy Brummel",
year = "2003",
month = "5",
day = "1",
language = "English (US)",
volume = "12",
pages = "220--230",
journal = "American Journal of Critical Care",
issn = "1062-3264",
publisher = "American Association of Critical Care Nurses",
number = "3",

}

TY - JOUR

T1 - A multisite survey of suctioning techniques and airway management practices

AU - Sole, Mary Lou

AU - Byers, Jacqueline F.

AU - Ludy, Jeffery E.

AU - Zhang, Ying

AU - Banta, Christine M.

AU - Brummel, Kathy

PY - 2003/5/1

Y1 - 2003/5/1

N2 - • BACKGROUND: Ventilator-associated pneumonia, common in critically ill patients, is associated with microaspiration of oropharyngeal secretions and may be related to suctioning and airway management practices. • OBJECTIVES: To describe institutional policies and procedures related to closed-system suctioning and airway management of intubated patients, and to compare practices of registered nurses and respiratory therapists. • METHODS: A descriptive, comparative, multisite study of facilities that use closed-system suctioning devices on most intubated adults was conducted. Nurses and respiratory therapists who worked at the sites completed surveys related to their practices. • RESULTS: A total of 1665 nurses and respiratory therapists at 27 sites throughout the United States responded. The typical respondent had at least 6 years' experience with patients receiving mechanical ventilation (61%) and a baccalaureate degree or higher (54%). Most sites had policies for management of endotracheal tube cuffs (93%), hyperoxygenation (89%) and use of gloves (70%) with closed-system suctioning, and instillation of isotonic sodium chloride solution for thick secretions (74%). Only 48% of policies addressed oral care and 37% addressed oral suctioning. Nurses did more oral suctioning and oral care than respiratory therapists did, and respiratory therapists instilled sodium chloride solution more and rinsed the suctioning device more often than nurses did. • CONCLUSIONS: Policies vary widely and do not always reflect current research. Consistent performance of practices such as wearing gloves for airway management and maintaining endotracheal cuff pressures must be evaluated. Collaborative, research-based policies and procedures must be developed and implemented to ensure best practices for intubated patients.

AB - • BACKGROUND: Ventilator-associated pneumonia, common in critically ill patients, is associated with microaspiration of oropharyngeal secretions and may be related to suctioning and airway management practices. • OBJECTIVES: To describe institutional policies and procedures related to closed-system suctioning and airway management of intubated patients, and to compare practices of registered nurses and respiratory therapists. • METHODS: A descriptive, comparative, multisite study of facilities that use closed-system suctioning devices on most intubated adults was conducted. Nurses and respiratory therapists who worked at the sites completed surveys related to their practices. • RESULTS: A total of 1665 nurses and respiratory therapists at 27 sites throughout the United States responded. The typical respondent had at least 6 years' experience with patients receiving mechanical ventilation (61%) and a baccalaureate degree or higher (54%). Most sites had policies for management of endotracheal tube cuffs (93%), hyperoxygenation (89%) and use of gloves (70%) with closed-system suctioning, and instillation of isotonic sodium chloride solution for thick secretions (74%). Only 48% of policies addressed oral care and 37% addressed oral suctioning. Nurses did more oral suctioning and oral care than respiratory therapists did, and respiratory therapists instilled sodium chloride solution more and rinsed the suctioning device more often than nurses did. • CONCLUSIONS: Policies vary widely and do not always reflect current research. Consistent performance of practices such as wearing gloves for airway management and maintaining endotracheal cuff pressures must be evaluated. Collaborative, research-based policies and procedures must be developed and implemented to ensure best practices for intubated patients.

UR - http://www.scopus.com/inward/record.url?scp=0038824724&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038824724&partnerID=8YFLogxK

M3 - Review article

VL - 12

SP - 220

EP - 230

JO - American Journal of Critical Care

JF - American Journal of Critical Care

SN - 1062-3264

IS - 3

ER -