The Status and Awareness of Suction Nursing Interventions Performed by Emergency Room Nurses

Purpose: This study aimed to observe endotracheal suctioning (ETS) procedures performed by emergency room nurses, identify factors that impede adherence to established guidelines, and propose specific strategies to improve compliance with these guidelines.Methods: The performance of ETS by emergency room nurses was observed in a simulated clinical environment, and adherence to established ETS guidelines was systematically assessed. Following, the simulation, semi-structured interviews were conducted with all participants to explore perceived barriers to guideline adherence.Results: Nineteen emergency room nurses participated in both the simulation and the interviews. Most participants did not adhere to recommended standards, particularly with respect to hand hygiene, and contamination frequently occurred during catheter handling. In addition, catheters larger than those recommended were commonly used, and inserted beyond the suggested depth. Many participants applied suction pressures that exceeded recommended levels and reported that the guideline-recommended pressure was ineffective for adequate secretion removal. Interview findings further indicated that participants perceived regular, customized training, that includes the rationale for each guideline component as necessary to enhance compliance.Conclusion: This study confirmed that emergency room nurses demonstrate inadequate adherence to ETS guidelines, particularly regarding catheter size selection, aseptic technique, and suction pressure management. These findings indicate a clear need for enhanced and targeted education addressing these areas. In addition to reaffirming previous research, this study provides insight into the underlying reasons for noncompliance with ETS guidelines, as identified through participant interviews.