Knowledge and practices of nurses caring for patients with endotracheal tube admitted to intensive care units in national hospital of Sri Lanka

Abstract

Background Artificial air way is utilized to facilitate mechanical ventilation and the endotracheal tube (ETT) is most used. The objective was to assess the intensive care unit (ICU) nurses’ knowledge and practice in caring for patients with endotracheal tube and their associated factors in National Hospital of Sri Lanka (NHSL). Materials and methods A cross sectional hospital-based study was done among nurses having more than 6 months working experience in all ICUs of NHSL. A self-administered questionnaire was developed using American Association of Respiratory Care (AARC) clinical Practice guideline 2010. Data was analyzed by using SPSS statistical package version 16. Results The majority (91%) had almost 10 years of ICU experience. Mean age was 31.74 years (SD± 5.69). Only half had good knowledge (50.8%) on endotracheal tube care. Mean knowledge was 69.7 ±12.662SD. Majority had good knowledge on oral care (98.9%), humidification (95.1%) and optimal cuff pressure (83.1%). Knowledge was poor for statements on “oral secretions may pool above the cuff leading to ventilator associated pneumonia” (VAP) (12%), selecting suitable suction catheter (44%) and relationship with vaporized water and micro-organism will lead to aspirations (18%). Reported correct practices was 57.8% (N= 107). Only 18% had practiced proper oral hygiene in mechanically ventilated patients. The majority (63.2%) reported incorrect practices related to suction method and measuring the suction catheter length. Conclusions Most nurses were unaware of the current protocols or guidelines related to ET tube care. The most significant deficiencies were related to tracheal complications and activities that cause tracheal trauma, and activities which can lead to serious and harmful effects to patients.