Problem: Hypoxemia and hypoxia-induced physiological changes are acknowledged complications of airway suctioning. Prior research recommends pre-oxygenation prior to suctioning as essential to prevent or minimize hypoxemia (Stone & Turner, 1989; Chulay, 1987; Stone, 1990). A pilot study indicated pre-oxygenation is performed during hospitalization; however, it is not routinely included in discharge instructions (Stevens, 1999). The purpose of this exploratory study was to describe pre-oxygenation practices of nurses who perform tracheal suctioning with individuals with spinal cord injury and identify decision making factors used when altering the method and frequency of pre-oxygenation. Framework: Patients who require routine tracheal suctioning demonstrate physiological adaptation. The Roy Adaptation Model and ventilatory acclimatization are used to explain decision-making process over time. Methodology: Members of the Association of Rehabilitation Nurses and American Spinal Cord Injury Association participated in a Web-based survey on pre-oxygenation practices and factors which contribute to a decision to do more or do less in terms of pre-oxygenation. Results: There were a total of 242 responses with 232 useable surveys. Pre-oxygenation is recommended prior to tracheal suctioning, however only twenty-five percent of the respondents (n=58) respondents indicated this as their practice. The larger number of respondents (n=174) indicated they either did not pre-oxygenate (n=43) or were active decision makers (n=131) choosing to pre-oxygenate some or most of the time based on patient, environmental or time factors. Cluster analysis methods identified different factors are used when making decision to do less or to do more in terms of pre-oxygenation. Results and differences in decision making patterns will be reported in the context of rehabilitation nursing practice. Relevance: Nurses play a crucial role teaching patients and families’ procedures, such as tracheal suctioning, necessary post-discharge. Little is known about how nurses make a decision to change the method and/or frequency of pre-oxygenation and its influence on discharge instructions.
Session #1223 - Graduate Student Poster Session
The 29th Annual MNRS Research Conference (April 1-4, 2005)