Sole Mary Lou, Bennett Melody
Mary Lou Sole is an Orlando Health distinguished professor and Pegasus professor, University of Central Florida, College of Nursing, and a research scientist at Orlando Health, Orlando, Florida. Melody Bennett is an adjunct faculty member, University of Central Florida, College of Nursing, and a staff nurse at Orlando Health.
Am J Crit Care. 2014 May;23(3):191-9; quiz 200. doi: 10.4037/ajcc2014424.
Airway management, an essential component of care for patients receiving mechanical ventilation, is multifaceted and includes oral hygiene and suctioning, endotracheal suctioning, and care of endotracheal tubes. Registered nurses and respiratory care personnel often share responsibilities for airway management. Knowledge of current practices can help facilitate evidence-based practices to optimize care of patients receiving mechanical ventilation.
To describe current practices for airway management of intubated patients and determine if practices differ between registered nurses and respiratory care practitioners.
A descriptive, comparative design was used. Registered nurses and respiratory care practitioners who provided direct care to intubated patients receiving mechanical ventilation were recruited to complete an online survey of self-reported practices.
A total of 85 participants completed the survey. Most were experienced caregivers with a bachelor's degree and certification or registration in their field. Selected practices have improved, including increasing oxygen saturation before endotracheal suctioning, maintaining pressure of endotracheal tube cuffs, and providing oral hygiene and suctioning. The practices of registered nurses and respiratory care practitioners differed in many ways. The nurses assumed responsibility for oral antisepsis, whereas the respiratory care practitioners managed the endotracheal tube. The 2 groups shared responsibility for oral and endotracheal suctioning. Knowledge of current guidelines for endotracheal suctioning was lacking.
Practices in airway management have improved, but opportunities exist to develop shared policies and procedures based on current evidence.
气道管理是接受机械通气患者护理的重要组成部分，涉及多方面内容，包括口腔卫生与吸痰、气管内吸痰以及气管内导管护理。注册护士和呼吸治疗人员通常共同承担气道管理职责。了解当前的实践有助于促进循证实践，以优化接受机械通气患者的护理。
描述气管插管患者气道管理的当前实践，并确定注册护士和呼吸治疗从业者之间的实践是否存在差异。
采用描述性比较设计。招募为接受机械通气的气管插管患者提供直接护理的注册护士和呼吸治疗从业者，以完成一项关于自我报告实践的在线调查。
共有85名参与者完成了调查。大多数是经验丰富的护理人员，拥有本科学位以及所在领域的认证或注册资格。部分实践有所改善，包括在气管内吸痰前提高氧饱和度、维持气管内导管套囊压力以及提供口腔卫生与吸痰。注册护士和呼吸治疗从业者的实践在很多方面存在差异。护士负责口腔消毒，而呼吸治疗从业者管理气管内导管。两组共同承担口腔和气管内吸痰的责任。对气管内吸痰当前指南的了解不足。
气道管理实践有所改善，但仍有机会根据当前证据制定共享的政策和程序。
