Nurses’ knowledge and skills in tracheostomy care

Actions of tracheostomy care as well as the technique of secretion suctioning from tracheostomy tube can influence the incidence of complications and determine patient‘s safety, possibility of recovery, the duration of treatment and the cost of treatment. It is critical for nurses to be aware of tracheostomy care recommendations based on scientific research and to apply them in clinical practice. The aim – to analyze nurses’ knowledge and skills in tracheostomy care. Objectives:1.To examine nurses’ knowledge on tracheostomy care prior to training and after the training. 2. To identify nurses’ skills while performing actions of tracheostomy care. 3. To compare nurses’ knowledge on tracheostomy care and their application in practice. Research methods: The research was conducted on 20-04-2013 - 20-12-2013 at the hospital of Lithuanian University of Health Sciences Kauno Klinikos in four departments and in one of the Nursing and supportive care hospital. A questionnaire created by the authors of the research and an observation protocol of nurses’ actions in practice was used to collect the data of the research. A survey on nurses’ was conducted twice: prior to training (n=90, response rate – 96.77%) and after the training (n=86, response rate – 92.47%). We observed 99 procedures of secretion suctioning from tracheostomy tube. The research was conducted with the approval BEC-KS (M)-198 from the center of Bioethics of Lithuanian University of Health Sciences. Conclusions. 1. Prior to the training the majority of nurses were properly aware of the symptoms, indicating the need of suctioning, the duration of suctioning, the depth of insertion of suctioning catheter, the possible secretion suctioning complications. After the training, significantly the majority of nurses performed action of suctioning according to the need and in shorter period of time, did not pour a isotonic solution into the tube. After the training approximately half of nurses surveyed indicated the wrong sequence of suctioning action and suctioning pressure. After the training the level of knowledge of nurses, who acquired education in medicine school and had a work experience for more than 10 years, significantly improved in comparison to the other groups of respondents. 2. In clinical practice, the majority of nurses performed the action of suctioning from tracheostomy tube according to the need, the level of catheter insertion depth was appropriate, did not pour a isotonic solution into tracheostomy tube. During the observation, the majority of nurses perform the suctioning action in the wrong sequence, about half of observed cases the suctioning action was prolonged and the pressure was too high. 3. In clinical practice, while performing the tracheostomy care, nurses properly applied knowledge of the need of secretion suctioning from tracheostomy tube, the depth of the suctioning catheter insertion, the use of a isotonic solution. However, the majority of nurses did not apply the recommended sequence of actions of secretion suctioning, half of nurses – the recommended pressure and duration of suctioning