title: Nasal continuous positive airway pressure: a multisite study of suctioning practices within NICUs.
abstract: OBJECTIVE
  The purpose of this multisite study was to describe suctioning techniques of registered nurses (RNs) and respiratory therapists (RTs) caring for neonates requiring nasal continuous positive airway pressure (CPAP). The care practices investigated included suctioning frequency, assessment parameters, and techniques used to suction.
  
  
  METHODS
  A convenience sample of neonatal intensive care unit (NICU) RNs and practicing RTs at 8 Midwestern hospitals in the United States caring for neonates on nasal CPAP in a level II or III NICU were included. Eighty-five percent of respondents were RNs of which almost 89% (88.6%) were staff RNs, 63% were bachelor prepared, and 33% of the RNs had greater than 20 years of neonatal nursing experience.
  
  
  METHODS
  A cross-sectional descriptive comparative design was used for this study.
  
  
  METHODS
  An investigator-developed Web-based survey pertaining to current practice concerns was developed by the research team. The 31-item survey tool consisted of 4 sections. The first section addressed the frequency of suctioning. The second section addressed assessment parameters used to determine the need for suctioning. The third section addressed the technique used to suction, including gloving techniques, hyperoxygenation, and the use of catheters in nares and mouth and suctioning devices. Demographic data, including staff position, level of education, years of nursing, and NICU experience and certification, were collected in the fourth section. Descriptive statistics were used to characterize demographics and each item of the survey. Chi-square statistics (Pearson chi-square and Fisher Exact text) were used to compare RNs' and RTs' nasal CPAP suctioning practices.
  
  
  RESULTS
  The results of this study indicated that decision making related to the need to suction was variable. In addition, the frequency of suctioning and nasopharyngeal and oropharyngeal suctioning techniques were highly variable for neonates requiring nasal CPAP.
  
  
  CONCLUSIONS
  Despite the treatment of respiratory distress with nasal CPAP, there are no best practice guidelines for providing nasopharyngeal and oropharyngeal suctioning for maintenance of a patent airway. Future randomized controlled clinical trials are needed to develop best practices for nasal CPAP suctioning.
authors.affiliation: Neonatal Intensive Care Unit, Wexner Medical Center, the Ohio State University, Columbus, OH 43218, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Mann
authors.forename: Michele
authors.initials: M
authors.lastname: Sweet
authors.forename: Amy M
authors.initials: AM
authors.lastname: Knupp
authors.forename: Jacalyn
authors.initials: J
authors.lastname: Buck
authors.forename: Esther
authors.initials: E
authors.lastname: Chipps
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000379:methods* / Q000592:standards; D003430:Cross-Sectional Studies; D003710:Demography; D004522:Educational Status; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D015146:Midwestern United States; D017283:Neonatal Nursing / Q000379:methods*; D009741:Nursing Staff, Hospital; D017410:Practice Guidelines as Topic; D013396:Suction / Q000379:methods*; D011795:Surveys and Questionnaires