중환자실 간호사의 인공호흡기 적용 환자 기관내 흡인 수행

다국어 초록 (Multilingual Abstract)

Performance of Endotracheal Suction in Mechanically Ventilated Patients in Nurses Working at Intensive Care Units


Yang, Eunjung
Graduate School of Kyung Hee University
(Directed by professor Shin, Hyun-Sook, RN, Ph.D.)


Purpose
This study aims to survey the performance status for endotracheal suction in nurses working at intensive care units (ICU) and to identify the factors associated with the performance status.

Methods
This study is a descriptive study to evaluate the performance status and its related factors to endotracheal suction. One hundred fifty five nurses working at ICU participated in this study. We used a questionnaire developed based on American Association for Respiratory Care (AARC) guidelines and other associated factors from previous studies.

Results
More participants practiced endotracheal suction when needed(52.9%) than routinely(40%). Almost participants always washed their hands pre and post suctioning(90.3%), changed suction catheter in every practices(97.4%), always adhered to the aseptic technique(78.7%). Almost participants used more frequently open suction system(74.8%) than closed suction system(20.7%), did hyperoxygenation(86.5%), did not hyperinflation(81.9%) and did normal saline instillation(76.1%) routinely or for thick secretions. Mean suction pressure is 114mmHg. Mean suction catheter size is 12Fr. Mean duration of suctioning is 15sec. More participants inserted most fully insertion suction catheters in suction catheter insert depth(45.8%). Around half of the participants reported that their compliance to the clinical guideline was inappropriate. Items deviated from the recommended guideline were the reason for initiating suctioning, applied suction pressure which ranged varied from 20 to 200mmHg, and used catheter size from 6 to 17Fr. Other factors deviated were the depth of inserted catheter, and inappropriate use of normal saline instillation. The most significant factor is related to hospital; the misused or misled clinical protocol.

Conclusion
The compliance to the clinical guidelines of the endotracheal suction in ICU nurses is not appropriate, which may contribute to the patient health outcomes. More enhanced continuing education as well as hospital regulation is warranted.



Key Words : Endotracheal, Suction, Intensive care unit, Guideline

목차 (Table of Contents)

• I. 서론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 4
• 3. 용어 정의 5
• II. 문헌고찰 6
• 1. 기관내 흡인 6
• 2. 기관내 흡인 방법 7
• 3. 기관내 흡인 임상실무지침 10
• 4. 기관내 흡인 수행의 관련요인 12
• III. 연구 방법 14
• 1. 연구 설계 14
• 2. 연구대상 14
• 3. 자료수집 14
• 4. 연구도구 14
• 5. 자료분석 15
• IV. 연구 결과 16
• 1. 대상자의 일반적 특성 16
• 2. 대상자의 흡인 관련 특성 18
• 3. 중환자실 간호사의 기관내 흡인 수행 현황 20
• 4. 중환자실 간호사의 기관내 흡인 수행 현황과 관련된 요인 26
• V. 논의 31
• VI. 결론 및 제언 38
• 1. 결론 38
• 2. 제언 40
• 참고문헌 42
• 부록 46
• 초록 55