University of Oulu

Jansson, M., Ala-Kokko, T., Ylipalosaari, P., & Kyngäs, H. (2013). Evaluation of endotracheal-suctioning practices of critical-care nurses – An observational correlation study. Journal of Nursing Education and Practice, 3(7).

Evaluation of endotracheal-suctioning practices of critical care nurses : an observational correlation study

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Author: Jansson, Miia1; Ala-Kokko, Tero2; Ylipalosaari, Pekka3;
Organizations: 1Institute of Health Sciences, University of Oulu, Finland, Finland
2Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
3Division of Intensive Care and Infection Control, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.1 MB)
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Language: English
Published: Sciedu Press, 2013
Publish Date: 2019-09-02


Background: Endotracheal-suctioning (ETS) is a procedure that may constitute a risk factor for ventilator-associated pneumonia (VAP) by increasing microbial colonization of the lower airway. Unsafe ETS practices have been observed worldwide during recent years. Because of adverse reactions, practioners need to take all necessary precautions to ensure patient safety and a high quality of nursing care. The aim of the present study was to evaluate critical-care nurses’ performance in relation to current recommendations in their daily practice prior to, during and post ETS events.

Methods: A structured, non-participatory, observational study (n=40) was conducted using a 25-item best-practice information sheet to assess critical-care nurses’ ETS practices in a mixed medical-surgical intensive-care unit. One-sample- and independent-samples t-tests were used to compare critical-care nurses’ ETS performance against current recommendations within different ICU experience groups.

Results: The quality of observed ETS practices was significantly lower than the required quality of care (p<0.001). The most significant discrepancies were observed in ETS practices related to infection-control practices.

Conclusion: Critical-care nurses are currently not following current ETS recommendations. Significant discrepancies, which may constitute a risk factor for VAP by increasing microbial colonization of the lower airway, were identified. Unsafe ETS practices may jeopardize patient safety, and thus the quality of nursing care. Educational interventions, clinical guidelines and adequate support need to be provided to critical-care nurses to assess and improve their professional capabilities and current practice. Regular auditing and prompt feedback would be beneficial.

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Series: Journal of nursing education and practice
ISSN: 1925-4040
ISSN-E: 1925-4059
ISSN-L: 1925-4040
Volume: 3
Issue: 7
Pages: 99 - 105
DOI: 10.5430/jnep.v3n7p99
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
316 Nursing
3141 Health care science
Funding: This study was financed by Oulu University Hospital.
Copyright information: © The Authors. 2013. Copyrights for articles published in our journals are retained by the authors, with first publication rights granted to the journal. The journal/publisher is not responsible for subsequent uses of the work. It is the author's responsibility to bring an infringement action if so desired by the author.