Comparison of Airway Management Practices Between Registered Nurses and Respiratory Care Practitioners

Abstract

BackgroundAirway management, an essential component of care for patients receiving mechanical ventilation, is multifaceted and includes oral hygiene and suctioning, endotracheal suctioning, and care of endotracheal tubes. Registered nurses and respiratory care personnel often share responsibilities for airway management. Knowledge of current practices can help facilitate evidence-based practices to optimize care of patients receiving mechanical ventilation.ObjectivesTo describe current practices for airway management of intubated patients and determine if practices differ between registered nurses and respiratory care practitioners.MethodsA descriptive, comparative design was used. Registered nurses and respiratory care practitioners who provided direct care to intubated patients receiving mechanical ventilation were recruited to complete an online survey of self-reported practices.ResultsA total of 85 participants completed the survey. Most were experienced caregivers with a bachelor’s degree and certification or registration in their field. Selected practices have improved, including increasing oxygen saturation before endotracheal suctioning, maintaining pressure of endotracheal tube cuffs, and providing oral hygiene and suctioning. The practices of registered nurses and respiratory care practitioners differed in many ways. The nurses assumed responsibility for oral antisepsis, whereas the respiratory care practitioners managed the endotracheal tube. The 2 groups shared responsibility for oral and endotracheal suctioning. Knowledge of current guidelines for endotracheal suctioning was lacking.ConclusionsPractices in airway management have improved, but opportunities exist to develop shared policies and procedures based on current evidence.