The accuracy of intensive care nurses' interpretation of chest radiographs to recognise misplacement of endotracheal and nasogastric tubes after a single training session and comparison with residents' interpretation
Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Misplacements of endotracheal and nasogastric tubes are frequent encounters in critically ill patients.
OBJECTIVES: The purpose of this study was to assess the effectiveness of a single standardised training session on the ability of intensive care registered nurses (RNs) to recognise the misplacement of endotracheal and nasogastric tubes on bedside chest radiographs of patients in intensive care units (ICUs).
METHODS: In eight French ICUs, RNs received a 110-min standardised teaching on the position of endotracheal and nasogastric tubes on chest radiographs. Their knowledge was evaluated within the subsequent weeks. For 20 chest radiographs, each with an endotracheal and nasogastric tube, RNs had to indicate whether each tube was in the proper or incorrect position. Training success was defined as >90% for the lower bound of the 95% confidence interval (95% CI) of the mean correct response rate (CRR). Residents of the participating ICUs underwent the same evaluation (without prior specific training).
RESULTS: In total, 181 RNs were trained and evaluated and 110 residents were evaluated. The global mean CRR for RNs was 84.6% (95% CI: 83.3-85.9), significantly higher than for residents (81.4% [95% CI: 79.7-83.2]) (P < 0.0001). The mean CRR for RNs and residents was 95.9% (93.9-98.0) and 97.0% (94.7-99.3) for misplaced nasogastric tubes (P = 0.54), 86.8% (85.2-88.5) and 82.6% (79.4-85.7) (P = 0.07) for nasogastric tubes in the correct position, 86.6% (83.8-89.3) and 62.7% (57.9-67.5) for misplaced endotracheal tubes (P < 0.0001), and 79.1% (76.6-81.6) and 84.7% (82.1-87.2) for endotracheal tubes in the correct position (P = 0.01), respectively.
CONCLUSIONS: The ability of trained RNs to detect tube misplacement did not reach the predetermined arbitrary level, indicating training success. Their mean CRR was higher than that for residents and was considered satisfactory for detecting misplaced nasogastric tubes. This finding is encouraging but insufficient to ensure patient safety. Transferring responsibility for reading radiographs to detect the misplacement of endotracheal tubes to intensive care RNs will need a more advanced or more in-depth teaching method.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Australian critical care : official journal of the Confederation of Australian Critical Care Nurses - 36(2023), 6 vom: 05. Nov., Seite 948-954 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kamel, Toufik [VerfasserIn] |
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| Links: |
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| Themen: |
Diagnostic |
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| Anmerkungen: |
Date Completed 13.11.2023 Date Revised 15.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.aucc.2023.01.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM353779784 |
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| 100 | 1 | |a Kamel, Toufik |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The accuracy of intensive care nurses' interpretation of chest radiographs to recognise misplacement of endotracheal and nasogastric tubes after a single training session and comparison with residents' interpretation |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 13.11.2023 | ||
| 500 | |a Date Revised 15.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Misplacements of endotracheal and nasogastric tubes are frequent encounters in critically ill patients | ||
| 520 | |a OBJECTIVES: The purpose of this study was to assess the effectiveness of a single standardised training session on the ability of intensive care registered nurses (RNs) to recognise the misplacement of endotracheal and nasogastric tubes on bedside chest radiographs of patients in intensive care units (ICUs) | ||
| 520 | |a METHODS: In eight French ICUs, RNs received a 110-min standardised teaching on the position of endotracheal and nasogastric tubes on chest radiographs. Their knowledge was evaluated within the subsequent weeks. For 20 chest radiographs, each with an endotracheal and nasogastric tube, RNs had to indicate whether each tube was in the proper or incorrect position. Training success was defined as >90% for the lower bound of the 95% confidence interval (95% CI) of the mean correct response rate (CRR). Residents of the participating ICUs underwent the same evaluation (without prior specific training) | ||
| 520 | |a RESULTS: In total, 181 RNs were trained and evaluated and 110 residents were evaluated. The global mean CRR for RNs was 84.6% (95% CI: 83.3-85.9), significantly higher than for residents (81.4% [95% CI: 79.7-83.2]) (P < 0.0001). The mean CRR for RNs and residents was 95.9% (93.9-98.0) and 97.0% (94.7-99.3) for misplaced nasogastric tubes (P = 0.54), 86.8% (85.2-88.5) and 82.6% (79.4-85.7) (P = 0.07) for nasogastric tubes in the correct position, 86.6% (83.8-89.3) and 62.7% (57.9-67.5) for misplaced endotracheal tubes (P < 0.0001), and 79.1% (76.6-81.6) and 84.7% (82.1-87.2) for endotracheal tubes in the correct position (P = 0.01), respectively | ||
| 520 | |a CONCLUSIONS: The ability of trained RNs to detect tube misplacement did not reach the predetermined arbitrary level, indicating training success. Their mean CRR was higher than that for residents and was considered satisfactory for detecting misplaced nasogastric tubes. This finding is encouraging but insufficient to ensure patient safety. Transferring responsibility for reading radiographs to detect the misplacement of endotracheal tubes to intensive care RNs will need a more advanced or more in-depth teaching method | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diagnostic | |
| 650 | 4 | |a Gastrointestinal | |
| 650 | 4 | |a Intensive care | |
| 650 | 4 | |a Intratracheal | |
| 650 | 4 | |a Intubation | |
| 650 | 4 | |a Nurses | |
| 650 | 4 | |a Residents | |
| 650 | 4 | |a X-ray | |
| 700 | 1 | |a Sauvage, Brice |e verfasserin |4 aut | |
| 700 | 1 | |a Lakhal, Karim |e verfasserin |4 aut | |
| 700 | 1 | |a Ottavy, Grégoire |e verfasserin |4 aut | |
| 700 | 1 | |a Janssen-Langenstein, Ralf |e verfasserin |4 aut | |
| 700 | 1 | |a Jacquier, Marine |e verfasserin |4 aut | |
| 700 | 1 | |a Larrat, Charlotte |e verfasserin |4 aut | |
| 700 | 1 | |a Jacq, Gwenaëlle |e verfasserin |4 aut | |
| 700 | 1 | |a Dauvergne, Jérôme E |e verfasserin |4 aut | |
| 700 | 1 | |a Maugars, Diane |e verfasserin |4 aut | |
| 700 | 1 | |a Labruyere, Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Simeon, Véronique |e verfasserin |4 aut | |
| 700 | 1 | |a Cugnart, Cécile |e verfasserin |4 aut | |
| 700 | 1 | |a Girault, Christophe |e verfasserin |4 aut | |
| 700 | 1 | |a Boulain, Thierry |e verfasserin |4 aut | |
| 700 | 0 | |a CRICS TRIGGERSEP Group (Clinical Research in Intensive Care and Sepsis Trial Group for Global Evaluation and Research in Sepsis) |e verfasserin |4 aut | |
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