• Rosanne Leddy and Jenny M Wilkinson.
• Department of Respiratory Therapy, The Mississauga Hospital, Mississauga, Ontario.
• Can J Respir Ther. 2015 Jan 1;51(3):60-4.

BackgroundA common procedure within intensive care units (ICUs) is the suctioning of respiratory secretions in patients who have been intubated or who have undergone tracheostomy. Previous studies have shown a wide variation in suctioning practices, and although current evidence does not support the routine practice of normal saline instillation (NSI), anecdotally, this is believed to be a common practice.ObjectiveTo examine the suctioning practices of registered nurses (RNs) and registered respiratory therapists (RRTs) in six hospital ICUs in Ontario, with special attention devoted to the use of NSI.MethodsA 24-question, self-administered survey was distributed to 180 participants (90 RNs and 90 RRTs) working in the ICU of six hospitals in Ontario. The survey addressed individual suctioning practices within the ICU.ResultsThe survey response rate was 96%. There were many similarities between the RRT and RN groups, with both reporting high use of NSI. Both groups observed side effects following NSI with suctioning including decreased oxygen saturation, patient agitation and increased volume of secretions. A significant number of participants from both the RN and RRT groups were unaware of the existence of suctioning and/or NSI protocols in the ICU. Some respondents reported that they routinely suctioned mechanically ventilated patients rather than as required.ConclusionRNs and RRTs continue to practice NSI despite evidence-based practice guidelines suggesting that this therapy may be detrimental to patients. Increased awareness of best practices with respect to endotracheal tube suction generally, and NSI specifically, should be the focus of professional education in both groups of ICU staff.

5 keywords...

hide…