Copnell B, Fergusson D
Royal Children's Hospital, Melbourne, Australia.
Am J Crit Care. 1995 Mar;4(2):100-5.
Although many investigators have assessed the technique of endotracheal tube suctioning, the tissue of how frequently it should be performed remains controversial. No objective data is available to determine the answer.
To determine the criteria nurses use to make decisions regarding endotracheal suctioning.
Twenty-four registered nurses of varying levels of experience were asked a series of open-ended questions related to their theoretical knowledge, their ability to apply this knowledge, their suctioning practice, and how they made decisions regarding suctioning.
All participants believed their patients required suctioning every 1 to 3 hours, with 17 performing it every 2 to 3 hours. Twenty criteria of which nine related to frequency were used in determining suctioning requirements. Eleven related to recognizing the need for immediate suctioning and were concerned with changes in the patient's condition. Common significant changes included desaturation, hemodynamic changes, loss of color, and blood gas changes. No single criterion was identified by all nurses. No differences were apparent between experienced and less experienced nurses.
The large number of criteria identified suggests that the decision to suction is a complex one. It is a concern that many nurses rely on a deterioration in the patient's condition to indicate when suctioning is required. A policy of suctioning as necessary is provision of clear guidelines and education of all staff.
尽管许多研究人员已对气管内插管吸痰技术进行了评估，但关于该操作的执行频率仍存在争议。目前尚无客观数据来确定答案。
确定护士在做出气管内吸痰决策时所使用的标准。
向24名经验水平各异的注册护士询问了一系列开放式问题，内容涉及她们的理论知识、应用该知识的能力、吸痰操作以及她们如何做出吸痰决策。
所有参与者都认为他们的患者每1至3小时需要吸痰一次，其中17人每2至3小时进行一次吸痰。在确定吸痰需求时使用了20条标准，其中9条与频率有关。11条与识别立即吸痰的需求有关，涉及患者病情的变化。常见的显著变化包括血氧饱和度下降、血流动力学变化、肤色改变和血气变化。没有一条标准被所有护士认可。经验丰富和经验不足的护士之间没有明显差异。
确定的标准数量众多表明吸痰决策是一个复杂的过程。令人担忧的是，许多护士依赖患者病情恶化来指示何时需要吸痰。制定必要时吸痰的政策需要为所有工作人员提供明确的指导方针和教育。
