Comparison of airway management practices between registered nurses and respiratory care practitioners.
BACKGROUND
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.


OBJECTIVE
To describe current practices for airway management of intubated patients and determine if practices differ between registered nurses and respiratory care practitioners.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Practices in airway management have improved, but opportunities exist to develop shared policies and procedures based on current evidence.
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.
Mary Lou
ML
Sole
Melody
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Bennett
D000328:Adult; D058109:Airway Management / Q000379:methods* / Q000451:nursing; D019317:Evidence-Based Medicine / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007442:Intubation, Intratracheal / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D009726:Nurses; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012121:Respiration, Artificial / Q000592:standards; D012138:Respiratory Therapy / Q000592:standards; D015144:Southeastern United States