Intensive Care Nurses’ Infection Prevention And Control Practices On Endotracheal Suctioning Using A Comprehensive Checklist And Influencing Factors In Consultant Hospitals In Dar Es Salaam

Abstract

Background: Endotracheal suctioning (ETS) is an invasive procedure performed to patients with artificial airway aiming at clearing accumulated pulmonary secretions. It can cause infection of the lower airway if not aseptically done. In studies conducted Nurses expressed adequate knowledge of the procedure while inadequate infection prevention and control practices (IPC) were observed for the few items assessed. Objective: The of the study was asses intensive care nurses’ IPC practice on ETS by using a comprehensive checklist and influencing factors in consultant hospitals in Dar es Salaam. Materials and Methods: This is a cross-sectional study design involving random sample of 129 ICU nurses from Muhimbili National Hospital, Muhimbili Orthopedic Institute and Jakaya Kikwete Cardiac Institute in Dar es Salaam. Among the 129 participants, 43% (n=55) were assessed for IPC practices on ETS using a comprehensive checklist prepared by the researcher through adapting the constructs from guidelines for ETS. All 129 participants were surveyed for hospital factors influencing a practice using a structured questionnaire. Data from both observation and survey were analyzed using SPSS version 23.0. Descriptive statistics where by frequency, percentage, mean and standard deviation used to analyze data, association of IPC practice and individual related factors was determined by using chi-square test, logistic regression tests was performed to determine significant association. Results: Majority (60%) who were observed for IPC practice on ETS scored 10 points (66.7%) which was a cutoff point for a desired level. Level of education in nursing whereby, those with bachelor and masters level show significant association with IPC practice (AOR=5, 95% CI=1.14-22.44, p value=0.03). Participants reported various factors within the hospital that influence IPC practice positively and negatively. Conclusion and recommendations: The observed IPC practice on ETS was desirable. There was a significant association between individual level of education in nursing and IPC practice. Hospital management should make sure that intensive care nurses are adequately supplied with equipment for ETS in order to maximize IPC practices. ICU nurses need to utilize effectively the available resources in order to maximize IPC practices for the better outcome of patients.