Semester

Summer

Date of Graduation

2024

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Department

Not Listed

Committee Chair

Aaron M. Ostrowski, DNP, APRN, CRNA

Committee Co-Chair

Eric J. Lindstrom, MSN, CRNA

Committee Member

Eric J. Lindstrom, MSN, CRNA

Abstract

Background: Use of manometers, inflating the endotracheal tube (ETT) cuff with a 5-mL syringe, displaying the pressure-volume loop (PV-L) on anesthesia machines, and auscultating with a stethoscope over the trachea have been shown effective in preventing ETT cuff overinflation in the operating room (OR). Purpose: The aims of this project were to implement and evaluate a best practice guideline for ETT cuff inflation in the OR. Methods: This project was conducted in several ORs at J.W. Ruby Memorial Hospital, in Morgantown, West Virginia. Participants included anesthesiologists, certified registered nurse anesthetists (CRNAs), student registered nurse anesthetists, residents, and medics. The ETT cuff pressures assessed were adult intraoperative patients undergoing surgical procedures with general anesthesia and endotracheal intubation. Interventions: Pre-and post-intervention ETT cuff pressures were measured using a manometer at induction. CRNAs received education as a PowerPoint presentation on three best practice methods: PV-L technique, 5-mL syringe technique, and stethoscope technique, with badge cards distributed. Results: Mean ETT cuff pressures decreased significantly between pre-intervention and post-intervention (p = .03). There was an increase in the percentage of anesthesia providers who utilized one of the three alternative methods for ETT cuff inflation from 4.76% (3/63) to 34.3% (22/64). Mean ETT cuff pressure decreased significantly when using a 5-mL syringe compared to a 10-mL syringe in both pre-intervention (p = .032) and post-intervention groups (p < .001). Conclusions: This project showed that implementing best practice methods for ETT cuff inflation in the OR when a manometer is unavailable was a feasible intervention to reduce overall mean ETT cuff pressures.

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