Knowledge of nurses on intercostal tube management in a tertiary care setting: an exploratory descriptive study

INTRODUCTION: Intercostal tube (ICT) management is a high-risk nursing competency where knowledge gaps can lead to significant patient morbidity and mortality. Although a critical skill, nursing knowledge in this area, particularly in low- and middle-income countries, is not well documented. This study aimed to assess knowledge of ICT management among nurses in Sri Lanka, identify specific knowledge gaps, and determine the factors associated with competency. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted between June and July 2024 in a national specialized respiratory hospital in Sri Lanka. A convenience sample of 145 registered nurses completed a validated 29-item self-administered questionnaire assessing knowledge in three domains: indications/insertion, maintenance/complications, and patient care/infection control. Data were analysed using descriptive statistics, independent sample t-tests, and one-way ANOVA. Statistical significance was established at p < 0.05. RESULTS: The mean age was 36.8 (SD=6.2) years, and they had a mean of 10.9 (SD=6.5) years of occupational experience. The mean total knowledge score was 70.5% (20.44 ± 4.12 of 29), with most nurses (64.8%) demonstrating a moderate level of knowledge. Significant and critical knowledge gaps were identified in high-risk areas, including infection control for wound care (20.7% correct), suction level management (36.6% correct) and fundamental physiology (44.1% correct). The lack of specialised training was the strongest predictor of lower knowledge scores; nurses with specific training scored significantly higher than those without it (mean=22.8 vs 19.2, t(143)=5.41, p<0.001). Higher educational attainment (p=0.005) and more years of experience (p=0.003) were also significantly associated with higher knowledge scores. CONCLUSIONS: Nurses have moderate foundational knowledge of ICT management, but this is undermined by critical, patient safety-threatening gaps in specific technical and infection control domains. The strong association between knowledge deficits and the absence of continuing education provides a clear mandate for healthcare institutions to implement targeted competency-based training programmes and standardized clinical protocols to bridge these gaps and improve patient safety.