Document Detail


Nasal Continuous Positive Airway Pressure: A Multisite Study of Suctioning Practices Within NICUs.
MedLine Citation:
PMID:  23532035     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: : 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.
SUBJECTS: : 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.
DESIGN: : 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.
PRINCIPAL 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:
Brenda Mann; Michele Sweet; Amy M Knupp; Jacalyn Buck; Esther Chipps
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in neonatal care : official journal of the National Association of Neonatal Nurses     Volume:  13     ISSN:  1536-0911     ISO Abbreviation:  Adv Neonatal Care     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101125644     Medline TA:  Adv Neonatal Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E1-9     Citation Subset:  IM    
Affiliation:
Neonatal Intensive Care Unit, Wexner Medical Center, the Ohio State University (Ms Mann and Ms Sweet); Department of Health System Nursing Quality, Research, Education, and Evidence-Based Practice, Wexner Medical Center, the Ohio State University (Ms Knupp and Drs Buck and Chipps), Health System Nursing Quality & Patient Safety (Ms Knupp), Wexner Medical Center, the Ohio State University, Columbus.
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