Effects of Endotracheal Suctioning Procedure Steps Applied in Intensive Care on Suctioning Complications

Yıl 2023, Cilt: 7 Sayı: 1, 101 - 114, 31.01.2023

İlkin Yılmaz , Dilek Özden , Gülşah Gürol Arslan

https://doi.org/10.46237/amusbfd.1139842

Bu makale için 31 Ocak 2024 tarihinde bir düzeltme yayımlandı. https://dergipark.org.tr/tr/pub/amusbfd/issue/83040/1429994

Öz

Objective: Suctioning procedures that are not carried out under guidelines lead to complications. The aim of the study is to determine suctioning procedure mistakes and complications related the procedure in an intensive care unit (ICU) where no standard suctioning guidelines were applied.
Methods: The study was used an observational research design in a tertiary ICU. The procedure steps of nurses during suctioning were observed; blood pressure, heart rate, respiratory rate, peripheral oxygen saturation, tidal volume values, development of arrhythmia and hemorrhagic secretion were monitored in patients just before and at the first and the fifth minutes after suctioning.
Results: A total of 210 suctioning procedures performed by 35 nurses on 45 patients were observed. Nurses’ frequent mistakes were applying suction pressure above 150 mmHg (99.5%) for more than 10 seconds (63.3%), not applying hyperoxygenation before and after suctioning (98.1%, 96.2), applying deep suctioning (97.6%), applying total suctioning procedure for more than 15 seconds (72.9%). Applying suctioning pressure for more than 10 seconds increased the risk of tachycardia by 3.074 times, hemorrhagic secretion risk by 2.790 times, tachypnea risk by 2.024 times, and desaturation risk by 5.496 times in the first minute. Applying suctioning pressure for more than 15 seconds increased the risk of diastolic hypotension by 15.108 times, the arrhythmia by 2.630 times in the first minute; tachycardia by 3.725 times, tachypnea by 2.750 times in the fifth minute.
Conclusion: Many incorrect procedures applied by nurses, which did not comply with the suctioning standards, led to significant physiological changes in patients.

Anahtar Kelimeler

Endotracheal suctioning, Procedure steps, Complications, Nursing, Intensive care

Yoğun Bakımda Uygulanan Endotrakeal Aspirasyon İşlem Basamaklarının Aspirasyon Komplikasyonlarına Etkisi

Bu makale için 31 Ocak 2024 tarihinde bir düzeltme yayımlandı. https://dergipark.org.tr/tr/pub/amusbfd/issue/83040/1429994

Öz

Amaç: Rehber önerileri doğrultusunda yapılmayan aspirasyon işlemleri komplikasyonlara yol açmaktadır. Çalışmanın amacı, aspirasyon standardı uygulanmayan bir yoğun bakım ünitesinde aspirasyon işlem basamaklarında sıklıkla yapılan hataları belirlemek ve aspirasyon komplikasyonlarını incelemektir.
Yöntem: Çalışma üçüncü basamak bir yoğun bakım ünitesinde gözlemsel desende yürütülmüştür. Hemşirelerin aspirasyon sırasındaki işlem basamakları gözlenmiş; hastaların aspirasyondan hemen önce ve sonrasındaki birinci ve beşinci dakikalarda kan basıncı, kalp atım hızı, solunum sayısı, periferal oksijen satürasyonu, tidal volüm değerleri, aritmi, hemorajik sekresyon gelişimi takip edilmiştir.
Bulgular: Toplam 35 hemşirenin 45 hastada uyguladığı 210 aspirasyon işlemi izlenmiştir. Hemşirelerin en sık yaptığı uygulama hataları 150 mmHg üstü aspiratör basıncını (%99.5) 10 sn’den fazla uygulama (%63.3), aspirasyon öncesi ve sonrası hiperoksijenasyon uygulamama (%98.1, %96.2), derin aspirasyon uygulama (%97.6), aspirasyonun toplam süresinin 15 sn’den fazla sürmesi (%72.9) olarak belirlenmiştir. On saniyeden fazla aspiratör basıncı uygulamak birinci dakikada taşikardi görülme riskini 3.074, hemorajik sekresyon riskini 2.790, takipne riskini 2.024, desatürasyon riskini 5.496 kat arttırmıştır. Toplam aspirasyon süresini 15 sn’den fazla uygulamak birinci dakikada diyastolik hipotansiyon riskini 15.108, aritmi riskini 2.630, beşinci dakikada taşikardi görülme riskini 3.725, takipne riskini 2.750 kat arttırmıştır.
Sonuç: Bu çalışmanın sonuçları, hemşirelerin aspirasyon standardına uygun olmayan birçok hatalı işlem yaptığını, hatalı yapılan her işlemin hastalarda önemli fizyolojik değişimlere yol açtığını göstermektedir.  

Anahtar Kelimeler

Endotrakeal aspirasyon, İşlem basamakları, Komplikasyon, Hemşirelik, Yoğun bakım, Endotracheal suctioning, Procedure steps, Complications, Nursing, Intensive care., Intensive care

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