Authors (including presenting author) :
Chung KWT (1), Chan HLO (1), Ip WHB (1), Chan MFE (1), Kwong SFS (1)
Affiliation :
(1) Physiotherapy Department, Ruttonjee Hospital
Introduction :
Open-airway suctioning is an Aerosol Generating Procedures (AGP), which involves the mechanical aspiration of secretions from the nasopharynx, oro-pharynx and trachea. It is performed by physiotherapists after chest clearance maneuvers for patients who are unable to clear their chest with effective coughing. Safety and effectiveness of the treatment rely on standard and individual technique, especially for junior staff. In light of COVID-19 pandemic, up-to-date infection control enhanced measures is particularly important to protect patients and physiotherapists.
Objectives :
- To provide training and standardization for all physiotherapists in open-airway suction procedures
- To update guidelines with enhanced measures by PTCOC in view of COVID-19 pandemic.
- To ensure physiotherapists can perform the procedures up to the required standard
Methodology :
Standardization and audit items were constructed with training to all staff in April 2021. The audit program was carried out from May to August 2021. It was an on-the-job assessment carried out when the physiotherapists were delivering treatments. 3 major criteria were audited, including pre-suction assessments and preparations (6 items), implementation of suctioning (20 items), and tidy-up and documentations (6 items).
Result & Outcome :
20 physiotherapists were audited by 3 assessors. 19 nasopharyngeal suctions and 1 oral endotracheal tube suction procedure were audited. In pre-suction assessments, all staff performed suctioning with adequate assessments on the indications, precautions and contraindications checking. 89.5% staff complied with the requirements for infection control, gave adequate explanations and received consents from the patients. In the implementation, more than 90% staff complied with good handling of the suction catheters and adjustment of suction pressure (9 items). More than 90% staff monitored patients’ conditions well during the whole procedures (5 items). In post-suctioning, 98% staff documented adequately of patients' conditions and level of sputum clearance, ensured the environments were neat. Individual onsite feedback after audit and in-service debriefing were conducted.
The audit process provided a platform for training and standardization of practice according to updated guidelines. It can ensure the delivery of the treatments are safe, effective and efficient. The audit will be implemented for all new staff, particularly before Sunday/ Holiday chest physiotherapy duties. Refresher training and re-audit will be carried out at regular intervals.
