Analisi dell'utilizzo del sistema di aspirazione tracheale chiuso da parte degli infermieri in terapia intensiva
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Abstract
BACKGROUND
Tracheal suctioning is one of the most common procedures performed in intensive cares units (ICU) that ensures airway patency and a good ventilator pattern in patients with OT tube or tracheostomy. This procedure can be carried out by two different devices: an open tracheal suction system (OTSS) and a closed tracheal suction system (CTSS), each with its own peculiarities.
After an analysis of the scientific literature, which supports the use of the CTSS, it was decided to conduct research in the intensive care units of Brotzu’s and Duilio Casula’s hospitals of the city of Cagliari, to analyse the actual use of the device by nurses, highlighting difficulties and doubts. The CTSS has always been the subject of discussion among nurses in ICU.
MATERIALS AND METHODS
The research study was carried out by performing random face-to-face interviews of nurses during data collection.
The interview consisted of eleven questions. At the same time, random observations of the CTSS’s use were made, using the Duilio Casula Hospital ICU’s protocol as a guide.
RESULTS
It was clear that the CTSS is used extensively, even daily. 62,5% of nurses believed that the CTSS was more effective, and 62,5% of the interviewed nurses reported using the device in all intubated and tracheostomy patients. However, 41,3% of nurses reported not using the device beacuse it was believed to have a lower suction capacity.
The observation’s results highlighted mistakes such as poor hand hygiene (89,5% of the observations), a failure to disconnect the probe from the suction system (63,15%), and repeated insertion of the probe (31,6%), and poor manual skills using the device (15,8%).
CONCLUSIONS
The analysis of the results highlighted how nurses had a good theoretical knowledge of the CTSS, but have been observed a lot of mistakes in the use of the device.
This suggests to consider the organization of practical re training courses in the intensive care units.
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