الفهرس | Only 14 pages are availabe for public view |
Abstract Mechanical ventilation is a vital, life-saving therapy for patients with dangerous illness and respiratory disorder. Endotracheal tube suction is a procedure which aims to maintain clear pathway by mechanically expelling accumulated pulmonary excretions in patients with artificial airways. This procedure is associated with consequences and risks as haemorrhage, lesions of the tracheal mucosa, infections, atelectasis, cardiovascular disorder, hypoxemia and increase intracranial pressure. Its major aim is to evacuate accumulated lung excretion in order to keep the air pathways permeability; provide sufficient oxygenation; avoid the risk of ventilator-associated pneumonia (VAP) and prevent atelectasis and pulmonary consolidation. Performing tracheal suction procedure is responsibility of the critical care nurse and she should exert all of her effort to minimize any complication that can arise from this procedure. Aim of the study: This study aimed to assess factors contributing to post suction hypoxemia in critically ill patients. Research question: What are the factors contributing to post suction hypoxemia in critically ill patients? Research Design: A descriptive exploratory design was utilized in this study. Summary 107 Research Setting: This study was carried out in the Intensive Care Units of Alexandria Main Abo Quir- Hospital. Subjects: A purposive sample of 66 patients of both genders was involved in the study based on the power analysis (Epi-info program) with the following information (population size = 88 over 4 months. Expected frequency = 50%, acceptable error =5 % confidence coefficient = 95 %. Number of subjects was estimated by the power analysis (Epi-info program). Convenient sample of all nurses working in intensive care unit at Alexandria Abo Quir hospital. Tools used to accomplish the aim of this study: Two tools were used for data collection: Tool (I): Patient related factors: which include 4 parts used to assess patients’ related factors contributing to post suction hypoxemia in critical ill patients. Tool (2): Nurses related factors: which include 2 parts used to assess nurses’ related factors contributing to post suction hypoxemia in critical ill patients? Results: The results of the study showed that: Regarding the demographic characteristics of the patients under the study, the findings of this study revealed that more than half of them were male. Summary 108 As regards marital status more than two third of them were married, more than half of them had high education, and more than three quarter of them were employed. Concerning the studied patients` history the current study showed that, more than half of them were smokers and had hypertension. Regarding the assessment data of the studied patients the present study revealed that, regarding diagnosis less than one fourth of them had DKA (Diabetic Ketoacidosis), hemorrhagic stroke, CAPG (coronary artery bypass graft), and RTA (route traffic accident) respectively. Concerning the intubation data of the studied patients the current study showed that, regarding the causes of intubation more than half of them had DLC (disturbed level of conscious). Regarding the comparison between the mean scores of the patients` physiological parameters before and after suctioning procedure, the current study showed that there were highly statistically significance differences between mean scores of the patients` physiological parameters before and after suctioning procedure in which p≤ 0.001 except for Hco3, there was insignificant difference before and after suctioning procedure in which p> 0.05. Concerning the demographic characteristics of the studied nurses, the findings of this study revealed that Summary 109 more than three quarters of them were in the age group of 18 ≥ 30 years old. As regards the total level of nurses’ knowledge regarding suctioning procedure, the current study showed that the majority of the studied nurses had unsatisfactory level of knowledge regarding suctioning procedure, while less than one fourth of them had satisfactory level of knowledge regarding suctioning procedure. Concerning the total level of the nurses’ performance of suctioning procedure, the present study illustrated that only about half of the studied nurses had satisfactory level of suctioning performance. Concerning the relation between the total nurses’ knowledge and the total practice regarding suctioning procedure, the present study revealed that there was a statistically insignificance relation between nurses’ total level of practice and total level of knowledge in which p> 0.05. As regards the relation between the nurses’ demographic characteristics and total nurses’ level of practice regarding suctioning procedure, this study showed that there were a statistically insignificance relation between nurses’ demographic characteristics and total nurses’ level of practice regarding suctioning procedure in which p> 0.05. Summary 110 As regards the relation between the nurses’ demographic characteristics and the total nurses’ level of knowledge regarding suctioning procedure, the present study clarified that there were a highly statistically significance relation between nurses’ age, qualification, and total years of ICU experience and total nurses’ level of knowledge regarding suctioning procedure in which p≤ 0.001, while there was a statistically significance relation between nurses’ total years of professional experience and total nurses’ level of knowledge regarding suctioning procedure in which p≤ 0.005 |