TABLE 2.
Responses to questionnaire items relating to knowledge of nursing care practices for the management of endotracheal tube cuff pressure.
| Knowledge items | Intervention 1 group (n1) |
Intervention 2 group (n2) |
||||||
|---|---|---|---|---|---|---|---|---|
| Pre |
Post |
Pre |
Post |
|||||
| n1.1 | % | n1.2 | % | n2.1 | % | n2.2 | % | |
| B1 Frequency of monitoring ETT cuff pressure | ||||||||
| 2 hourly | 7 | 28 | 0 | 0 | 5 | 22 | 4 | 15 |
| 4 hourly | 2 | 8 | 1 | 4 | 0 | 0 | 0 | 0 |
| 6 hourly | 4 | 16 | 1 | 4 | 0 | 0 | 1 | 4 |
| 12 hourly? | 2 | 8 | 19 | 76 | 7 | 30 | 19 | 70 |
| Whenever a leak occurs | 8 | 32 | 2 | 8 | 8 | 35 | 2 | 7 |
| Never | 2 | 8 | 2 | 8 | 3 | 13 | 1 | 4 |
| B2 Methods used to monitor ETT cuff pressure | ||||||||
| Listening for air leaks | 8 | 32 | 2 | 8 | 7 | 30 | 4 | 15 |
| Use of minimal occlusive volume technique (MOV) | 0 | 0 | 2 | 8 | 0 | 0 | 6 | 22 |
| Use of minimal leak technique (MLT) | 2 | 8 | 0 | 0 | 0 | 0 | 2 | 7 |
| Use of an aneroid manometer? | 0 | 0 | 6 | 24 | 1 | 4 | 8 | 30 |
| Palpating the cuff with fingers to estimate the pressure in the cuff | 15 | 60 | 15 | 60 | 15 | 65 | 7 | 26 |
| B3 Position of the patient during the monitoring of ETT cuff pressure | ||||||||
| Supine and flat | 5 | 20 | 2 | 8 | 7 | 32 | 0 | 0 |
| Supine to up to 30° | 7 | 28 | 8 | 33 | 2 | 9 | 5 | 19 |
| Supine 30°–45°? | 7 | 28 | 10 | 42 | 5 | 23 | 16 | 62 |
| Supine 45°–90° | 1 | 4 | 0 | 0 | 0 | 0 | 0 | 0 |
| Lateral position | 1 | 4 | 2 | 8 | 0 | 0 | 0 | 0 |
| No change in position | 4 | 16 | 2 | 8 | 8 | 36 | 5 | 19 |
| B4 Recommended ETT cuff pressure to be maintained | ||||||||
| 18–22 cmH2O | 6 | 24 | 15 | 60 | 2 | 9 | 10 | 38 |
| 23–25 cmH2O | 3 | 12 | 0 | 0 | 3 | 13 | 2 | 8 |
| 26–30 cmH2O? | 1 | 4 | 7 | 28 | 2 | 9 | 9 | 35 |
| > 31 cmH2O | 0 | 0 | 0 | 0 | 2 | 9 | 0 | 0 |
| Do not know | 15 | 60 | 3 | 12 | 14 | 61 | 5 | 19 |
| B5 Management of audible leaks | ||||||||
| Inflate air despite the air already in the cuff till a leak is not heard any more? | 9 | 36 | 12 | 48 | 6 | 26 | 10 | 40 |
| Notify the physician/anaesthetic doctor/surgeon? | 8 | 32 | 9 | 36 | 16 | 70 | 7 | 28 |
| Change position of ETT and patient | 1 | 4 | 0 | 0 | 0 | 0 | 0 | 0 |
| Assess and palpate for cuff pressure | 7 | 28 | 4 | 16 | 1 | 4 | 8 | 32 |
| B6 Amount of air used to inflate an ETT cuff | ||||||||
| 2 mL | 7 | 28 | 5 | 20 | 7 | 30 | 4 | 15 |
| 5 mL | 5 | 20 | 2 | 8 | 3 | 13 | 5 | 19 |
| 10 mL? | 3 | 12 | 6 | 24 | 1 | 4 | 7 | 27 |
| 20 mL | 1 | 4 | 0 | 0 | 0 | 0 | 0 | 0 |
| Inflate till leak disappears despite the air volume already present in the cuff | 3 | 12 | 8 | 48 | 8 | 35 | 10 | 38 |
| Do not know | 6 | 24 | 0 | 0 | 4 | 17 | 0 | 0 |
| B7 Complications of under-inflation of the ETT cuff pressure | ||||||||
| Aspiration of gastric contents | 11 | 44 | 8 | 33 | 11 | 48 | 8 | 32 |
| Increase chances of ventilator-associated pneumonia | 5 | 20 | 5 | 21 | 4 | 17 | 5 | 20 |
| All the above? | 9 | 36 | 11 | 46 | 8 | 35 | 11 | 41 |
| None of the above | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 4 |
| B8 Complications of overinflation of the ETT cuff pressure | ||||||||
| Tracheal erosion | 3 | 12 | 1 | 4 | 9 | 39 | 0 | 0 |
| Tracheal stenosis | 5 | 20 | 7 | 28 | 7 | 30 | 12 | 46 |
| Tracheal rupture | 6 | 24 | 1 | 4 | 2 | 9 | 3 | 12 |
| Tracheal innominate artery fistula | 1 | 4 | 2 | 8 | 0 | 0 | 0 | 0 |
| All the above? | 9 | 36 | 14 | 56 | 5 | 22 | 10 | 38 |
| None of the above | 1 | 4 | 0 | 0 | 0 | 0 | 1 | 4 |
Note: Correct responses are indicated using a dagger sign.
ETT, endotracheal tube.