PEDIATRIC NURSES’ KNOWLEDGE AND SKILLS IN EVIDENCEBASED TECHNIQUE OF SECRETION SUCTIONING FROM A TRACHEOSTOMY TUBE

Abstract

In order to ensure the quality of tracheostomy care, nurses should have good knowledge and practical skills based on evidence-based practice. This study aims to analyse pediatric nurses’ knowledge and skills in evidence-based technique of secretion suctioning from tracheostomy tube. The study was conducted in the Pediatric Intensive Care Unit and three pediatric units. Questionnaire and Protocol for observation of practical skills were created. Sixty-nine nurses were questioned and thirty-two procedures of secretion suctioning from a tracheostomy tube observed. Nearly a fifth of the respondents (23.2%) indicated that it was usual to perform the secretion suctioning from a tracheostomy tube every few hours, during observations nurses performed secretion suctioning if at least one of the clinical criteria for the need of secretion suctioning was met. In practice, the pressure during procedure was set at 50-120 mmHg in the majority of procedures (95.5%), even though more than a half of the respondents (53.6%) indicated they performed secretion suctioning using the pressure higher than 150 mmHg or the highest pressure avai­lable in the pump. In practice, pediatric nurses providing tracheostomy care correctly applied their knowledge on the need for secretion suctioning from a tracheostomy tube. About a third of pediatric nurses did not follow the recom­mended steps of secretion suctioning procedure; in some cases the recommended suctioning pressure was not applied. In order to ensure patient’s safety and qualified tracheostomy care we have to rely on evidence–based nursing. Nurses not always know and use evidence - based tracheostomy care recommendations. This study revealed problematic aspects in tracheostomy care and proved that standardized tracheostomy care protocols have to be implemented, tracheostomy care study program for nurses based on evidence–based practice must be prepared, and tracheostomy teams in the hospitals have to be established.