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Metas de Enfermería

Metas de Enfermería

FEBRERO 2012 N° 1 Volumen 15

Implementation of an evidence-based endotracheal secretions aspiration protocol at the Intensive Care Unit

Section: Cover story

How to quote

Bejarano J et ál. Implantación de un protocolo de aspiración de secreciones endotraqueales basado en la evidencia científica en UCI. Metas de Enferm feb 2012; 15(1): 8-12

Authors

1Julián Bejarano Montañez, 1Sandra de la Calle Real, 1José Ángel Notario del Prado, 1Tatiana Sánchez Garrido

Position

1Enfermeros. Unidad de Cuidados Intensivos. Hospital Infanta Elena. Valdemoro (Madrid).

Contact address

Julián Bejarano Montañez. Hospital Infanta Elena. UCI - 2ª planta. Avda. Reyes Católicos, 21. 28342 Valdemoro (Madrid).

Contact email: jbej75@telefonica.net

Abstract

Objective: To assess the impact that the implementation of an evidence-based endotracheal secretions aspiration protocol has on the application of this technique.
Methods: Before and after interventional study developed at one Intensive Care Unit (Madrid), where an evidence-based endotracheal aspiration (EA) protocol was implemented after conducting training sessions with the nursing team. The study population consisted of EA patients that required mechanical ventilation for more than 48 hours. Study variables: reason for aspiration, caliber of the catheter used, hand washing, use of mask, prior hyperoxygenation, sedation level, and frequency of complications. For the before-after comparison of the implementation of the protocol the chi-square test and Fisher exact test were used.
Results: Before the implementation of the observation protocol, 482 aspirations from 11 patients were observed; and after implantation, 216 aspirations from 9 patients were observed also. A statistically significant improvement (p <0.05) was observed compared to what had been observed before the implementation of the protocol in the five items of general measures relating to the performance of the technique. Regarding the reasons of aspiration, no routine aspiration was performed, the main reason being the presence of secretions (66%). Only two types of complications developed: desaturation (3.7%) and obstruction of the tube (2.3%).
Conclusions: The application of an evidence-based protocol for the aspiration of endotracheal secretions implemented after conducting three training sessions with the nursing team increases compliance to the general rules for the correct application of the technique and decreases the incidence of complications, which translates into improved patient safety.

Keywords:

Aspiration; catheters; critical care; evidence-based practice; experimental design; investigation; protocolsecretions

Versión en Español

Título:

Implantación de un protocolo de aspiración de secreciones endotraqueales basado en la evidencia científica en una Unidad de Cuidados Intensivos

Artículo completo no disponible en este idioma / Full article is not available in this language

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