Knowledge assessment of respiratory therapists on endotracheal tube suctioning in intensive care units of public hospitals in Sana’a, Yemen

Abdul Fattah Al-Jaradi, Fares N AL-Wajeeh, Ahmed M AL-Khawlani, Alaa M Al-Jahshari, Aziz M Hisan, Hamza A AL-Gonaid, Alhasan A Seraj, Mohammed H Al-Khawlani, Makram A Mohamed Moqbel, Yahay M Munss, Hamdi A Al-Hamdi, Mohammed A AL-Gohaly

Abstract

Background

Endotracheal suctioning involves the insertion of a suction catheter into the patient’s trachea to remove and prevent the accumulation of secretions in the lungs of patients undergoing mechanical ventilation. Respiratory therapists are responsible for this procedure, so they must have strong knowledge of airway clearance in general, and endotracheal tube suctioning specifically, to implement the suction procedure without complications and with maximum benefit.

Methods

A descriptive study was conducted, including all respiratory therapists working in public hospitals in Sana’a City, Yemen, who were invited to participate. A self-administered questionnaire was used to collect data. Twenty questions were used to assess the participants’ knowledge. Scores were classified as high if above 80%, intermediate if between 70-80%, and low if below 70%. Descriptive statistics were used to interpret demographic data and descriptive measures. The chi-square test for categorical data was used to find the association between knowledge level and demographic characteristics, with a P-value ≤ 0.05 considered significant.

Results

About two-thirds (68%) of participants were male, and 69% were between 21 and 30 years old. 98% of participants had a three-year diploma degree, and 78% had 1-5 years of experience. More than four-fifths (83%) of participants had training courses in airway clearance, and three-quarters (75%) had training in endotracheal tube suctioning techniques. 5% of participants had a high level of knowledge about ETT suctioning and answered the study questions correctly, while 11% had moderate knowledge. More than two-thirds (84%) of participants had low-level knowledge, as defined by the study questionnaire results. There was a significant association between the level of education and knowledge of the respiratory therapists toward endotracheal tube suctioning with p–value (0.025). In contrast, there was no association between each of the variables ( Age, years of Experience) and the level of knowledge and endotracheal tube suctioning.

Conclusions

There is a significant association between educational level and the level of knowledge of respiratory therapists regarding endotracheal tube suctioning. We recommend that respiratory therapists advance their knowledge in airway clearance, specifically endotracheal tube suctioning, through continuous training based on evidence-based best practices.

Keywords: Endotracheal tube suction, knowledge, Respiratory therapists.

References

1. Blakeman TC, Scott JB, Yoder MA, et al. AARC clinical practice guidelines: Artificial airway suctioning. Respir Care 2022; 67(2):258-271. https://doi.org/10.4187/respcare.09548 PMid:35078900

2. Cairo JM. Pilbeam’s Mechanical Ventilation. Ventilator Graphics 6th edition. St Louis: Mosby, Elsevier; 2016; 121-123.

3. Martin Hughes, Roland Black. Advanced Respiratory Critical Care. 2nd Edition. Oxford University Press; 2011:224-225. https://doi.org/10.1093/med/9780199569281.001.0001

4. Elbokhary R, Osama A, Al-khader M. Knowledge and practice of ICU nurses regarding endotracheal suctioning for mechanically ventilated patients in Khartoum Teaching Hospital. American Journal of Clinical Neurology and Neurosurgery 2015;1(2):92-98.

5. Cairo JM. Pilbeam’s Mechanical Ventilation, 6th edition. St. Louis: Mosby; 2015:152-160.

6. Bano H, Hussain M, Afzal M, et al. Measurement of knowledge and performance of pediatric ICU nurses about endotracheal suctioning. Journal of Health Medicine and Nursing 2020; 73:80-88.

7. Carlon GC. Egan’s fundamentals of respiratory care, 11th edition. St Louis: Mosby, Elsevier; 2011; 1260.

8. Maggiore SM, Lellouche F, Pignataro C, et al. Decreasing the adverse effects of endotracheal suctioning during mechanical ventilation by changing practice. Respir Care 2013t; 58(10):1588-1597. https://doi.org/10.4187/respcare.02265 PMid:23466423

9. Nasreldeen MAA, Ashraf AE. Assessment knowledge and practical of nurses regarding endotracheal tube care in critical care Omdurman hospital. Int J of Allied Med Sci and Clin Research 2022; 10(1):51-59.

10. Shrestha S and Shrestha R (2018). Knowledge and Practice Regarding Endotracheal Suctioning among Nurses of Selected Teaching Hospitals, Bharatpur, Chitwan. Acta Scientific Medical Sciences 2018; 2(6):10-16. https://doi.org/10.52547/jmj.16.3.10

11. Gilder E, Parke RL, Jull A, et al. Endotracheal suction in intensive care: A point prevalence study of current practice in New Zealand and Australia. Aust Crit Care 2019; 32(2):112-115. https://doi.org/10.1016/j.aucc.2018.03.001 PMid:29665981

12. Majeed HM. Assessment of knowledge and practices of intensive care unit nurses about endotracheal suctioning for adult patients in Baghdad teaching hospitals, Iraq. Int J Res Med Sci 2017; 5(4):1396-1404. https://doi.org/10.18203/2320-6012.ijrms20171234

13. Ncube C. Intensive care nurses’ knowledge of evidence-based guidelines regarding endotracheal suctioning in an academic hospital in Johannesburg. Accessed January 2025, available at https://wiredspace.wits.ac.za/server/api/core/bitstreams/98518c5e-39e6-4e9c-a461-f25d6e07b6f7/content

14. Bülbül Maraş G, Kocaçal Güler E, Eşer İ, et al. Knowledge and practice of intensive care nurses for endotracheal suctioning in a teaching hospital in western Turkey. Intensive Crit Care Nurs 2017;39:45-54. https://doi.org/10.1016/j.iccn.2016.08.006 PMid:27876409