A survey of suctioning practices among physical therapists, respiratory therapists and nurses.

Abstract

To assess the current tracheal and oropharyngeal suctioning practice variability within and among the professions of physical therapy, respiratory therapy and nursing. A mail survey of physical therapists, respiratory therapists and registered nurses who perform suctioning. The survey instrument consisted of questions about professional characteristics, clinical suctioning practice and sociodemographics. The survey was restricted to professionals practising within the province of Ontario. Random samples (n=448) were drawn from membership of the regulatory boards of all three professions. Fifty-eight per cent of respondents returned completed questionnaires. There was large variation in reports of gloving procedure (eg, double clean: 26% for physical therapists, 5% for respiratory therapists, 55% for registered nurses, P<0.0001) and technique of catheter use (sterile, inline or clean, P<0.01). There was also discrepancy in the techniques used to minimize harmful effects, ie, prelubrication with gel (83% for physical therapists, 54% for respiratory therapists, 17% for registered nurses, P<0.0001), use of hyperinflation (12% of physical therapists, 25% of respiratory therapists, 39% of registered nurses never hyperinflate) and use of instillation (7% of physical therapists, 0% of respiratory therapists, 19% of registered nurses never instill). However, there was agreement about the routine application of hyperoxygenation (74% or more) and there was almost perfect agreement (99% or more) within and across the three professions that secretion removal was the main indication for suctioning. The results of this study indicate a wide variation in suctioning techniques among physical therapists, respiratory therapists and registered nurses. Comparisons among professions revealed inconsistencies in some areas, such as the use of in-line catheters, gloving procedures, prelubrication and hyperinflation.