Date of Award

2017

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Committee Chair

Ellise D. Adams

Subject(s)

Neonatal intensive care., Airway (Medicine)

Abstract

Background: An extensive review of the literature revealed a lack of standardized criteria or guidelines for suctioning in the Neonatal Intensive Care Unit (NICU). Most literature indicates the harmful effects of suctioning including bradycardia, desaturation of oxygen, apnea, inflammation of airways, and/or bronchospasms. Methods: The study was a descriptive, retrospective chart review to analyze airway clearance practices in a level III regional NICU from 2016-2017. There were 87 participants and 384 suctioning events total between the gestational ages of 32 weeks -36 weeks and 6 days. Practices reviewed include suctioning via inline suction, soft tip “Little Sucker”, and bulb syringe to determine the frequency, color, consistency, and tolerance of airway clearance. Participants who underwent surgery with general anesthesia or who were not admitted and discharged from the facility were excluded. No participant was excluded based on age, gender, or ethnicity. Results: Males in the suctioned population required more ventilatory assistance (53%). Neonates born via cesarean section required more suctioning (65.5%). Eighty-five percent of participants required a form of ventilatory assistance. After suction events, nurses reported no distress (74%), equal bilateral breath sounds (30%), desaturation (6%), and color change, apnea, or bradycardia <1% of the time. Discussion: Electronic medical records promote less detailed, narrative documentation and more button focused charting. This could hinder the evidenced-based use of airway clearance of the NICU patient. Results indicate the routine use of airway clearance (without indication) in the NICU setting as evidenced by no indication of distress (74%) and breath sounds clear and equal immediately after suctioning in 30% of events. More studies are needed to evaluate suction practices applied in the NICU setting.

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