Management of tracheobonchial secretions in different health care facilities in German-speaking countries – results from an interdisciplinary online survey

Background: Management of tracheobronchial secretions is an integral part of clinical work in many specialist areas, contributing to respiratory stability and survival of the patients. This study aimed at recording the practice of secretion management among doctors, respiratory therapists, specialist nurses and other health professions in German-speaking countries and to derive measures from the results to improve patient care. Methods: An online survey with 15 closed and two open-ended questions was designed to collect information regarding the profession and working environment of the respondents as well as the practice of secretion management in their primary working environment. The survey was distributed to members of the German Interdisciplinary Society for Out-of-Hospital Ventilation and Intensive Care e.V. (DIGAB), the German Society for Neurorehabilitation e.V. (DGNR), the German Society for Respiratory Therapy e.V. (DGA) and the German Society for Pulmonology and Mechanical Ventilation e.V. (DGP). Findings: The invitation to participate in the survey was distributed to 1695 members of the DIGAB, DGNR, DGA and DGP. Two-hundred fifty-eight health professionals including doctors, respiratory therapists, nurses, pediatric nurses, speech and language therapists and physiotherapists mostly working in Germany (97 %) completed the survey. One-Hundred eighty-eight (73 %) worked in hospitals or rehabilitation facilities and seventy (27 %) in an in-community setting. The spectrum of diagnostic and therapeutic methods used for management of tracheobronchial secretions on a daily or routine basis differed between hospitals or rehabilitation facilities and the in-community setting, between ICUs, weaning units and wards with specialization in ENNR, between in-community intensive care in the home of the patients and in residential communities, and between respondents treating only children, both children and adults, and only adults. Interpretation: A consensus on proceedings for the management of tracheobronchial secretions is required, which again requires further research into the differences regarding the practice of secretion management observed in this study. Standardized proceedings for the management of tracheobronchial secretions should be implemented by national treatment guidelines or local standard operating procedures.