Sunctioning

As Schwenker (et al., 1998) argues, " instilment of regular saline solution during suctioning via an endotracheal or a tracheotomy tube is contentious" (255). This creates a clinical problem, since the practice is a commonplace nurse intervention.

The significance of the problem is that custom of suctioning and perceptions of its use by nurses and respiratory therapists are important to understand. Because of the controversial nature of the intervention, nursing form _or_ system of government related to suctioning cannot be effectively implemented without an understanding of its use among professionals.

The review of the literature is done in a studious manner. It consists of approximately 20% of the document in length. Because of the controversy surround the suctioning intervention, the authors provide a review of the literature covering what is already known on the topic. The authors take us through a history of what is known on the topic, from the depression comprehensive studies conducted to ones conducted on nurses practicing the technique.

The articles reviewed are significant to the problem under investigation. The authors provide development on techniques of tracheal aspiration, instillment of normal saline, the effect of

instillation of normal saline on oxygen saturation, a mountain on removed endotracheal tubes, and a survey on pediatric nurses working in ICU.

Instillation of normal saline before suctioning is a common practice. The authors consecrate devised the present knowledge to determine if such practices are base on myths or actual benefits of the practice.

As the authors note about(predicate) their survey, "Questions were devised to test knowledge of this literature and to determine current practices of ingraining saline before suctioning" (Schwenker, et al., 1998, 257).

All five of the studies included in the literature review are empirically based. Demers and Saklad (1973) provide the first comprehensive review of techniques of tracheal aspiration. Bostick and Wendelgass (1987) conducted the largest study on instillation of normal saline. Ackerman's (1993) study focuses on the effective of normal saline on oxygen saturation measured by nervous impulse oximetry in 40 male subjects requiring mechanical ventilation (Schwenker, et al., 1998, 256). The study by Hagler and Traver (1994) was conducted on removed endotracheal tubes and conducted a study to kick downstairs contamination. The final study in quantitative in nature, utilizing the survey methodology similar to the authors' approach. Pediatric ICU nurses were surveyed by Swartz (et al., 1996) in order to determine the percentage of nurses who were utilizing instillation of normal saline before suctioning.

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