중환자실 간호사의 기관내 흡인 임상지침 수행 현황
Adherence to Clinical Guideline for Endotracheal Suction in ICU Nurses
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초록
이 연구는 중환자 간호사가 기관내흡인 시행의 임상가이드라인 이행정도와 가이드라인 이행에 영향을 미치는 요소를 파악하는 것이다. 연구방법은 기관내흡인 임상가이드라인 이행 현황과 관련요인을 질문지를 통해 파악하는 기술적 조사연구이다. 연구결과: 참여자중 50% 이상이 기관내흡인 임상가이드라인대로 이행하고 있지 않은 것으로 보고하였다. 흡인을 시작하는 근거, 적용하는 흡인압, 카테터 크기, 카테터 삽입깊이, 생리식염수 점적의 부적절한 활용 등이 보고되었다. 결론: 기관내흡인이 임상가이드라인에 의해 적절하게 사용되어 환자성과에 긍정적인 영향을 미칠 수 있도록 간호현장에서의 가이드라인 적용에 대한 보다 깊이있는 분석이 필요할 것이다.
Abstract
Purpose: This study aimed to evaluate the adherence to the clinical guideline for endotracheal suction in nurses working at intensivecare units (ICU) and to identify the characteristics of nurses with good adherence. Methods: This study was a descriptive study toevaluate the pattern of adherence and its related factors to endotracheal suction. One hundred fifty five nurses working at ICU participatedin this study. We used a questionnaire developed based on American Association for Respiratory Care (AARC) guidelines and otherassociated factors from previous studies. Results: Around half of the participants reported that their adherence to the clinical guidelinewas poor. Items deviated from the recommended guideline were reasons for initiating a suctioning, applied suction pressure rangedfrom 20 to 200mmHg, and applied catheter size from 6 to 17 french. Other factors deviated were the depth of inserted catheter, andinappropriate use of normal saline instillation. The most significant factor was related to hospital; the misused or misled clinical protocol. Conclusions: The adherence to the clinical guidelines of the endotracheal suction in ICU nurses was not appropriate, which mightcontribute to the patient health outcomes. More enhanced continuing education as well as hospital regulation is warranted.
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