End-Tidal Capnography Use by Registered Nurses in a Rural Appalachian Acute Care Hospital

Purpose: The utilization of capnography is an important part of care to patients in the emergency department or intensive care unit with respiratory complaints. The researcher personally noted nurses not routinely using this technology, even though the capabilities were made available to them. This research project was developed to answer the research question: “What are the perceived barriers that registered nurses in a rural Pennsylvanian hospital have to the utilization of end-tidal capnography?

Methods: The study employed an anonymous, researcher-developed data collection tool which was made available to 25 nurses in the emergency department and intensive care unit at a rural acute care hospital in northwest Pennsylvania. The data collection tool consisted of two demographic questions, asking what academic nursing degree the respondent held, and how long they have practiced nursing. The data collection tool then had eight Likert-type items related to the nurse's perceived barriers of capnography use. The data was then tabulated and analyzed using quantitative descriptive statistics.

Results: There were 12 nurses who completed the study, indicating a 48% response rate.  The data obtained from this research project revealed that the participants indicated that they knew how to use the capnography equipment available at the study hospital.  The participants were divided about receiving adequate training on the indications and clinical significance of capnography.  Approximately 49% answered that they had received adequate training, and 49% answered that they have not received adequate training on the indications and clinical significance of capnography.  However, 67% of the study participants reported that they know the indications of capnography and what the results mean; likewise, 92% of respondents stated that they do understand the clinical significance that capnography has.  The Likert items which asked if the nurses had current knowledge of capnography were answered in the affirmative, yet half of the participants reported not having adequate training on the subject.  The respondents indicated that they do seek out new technologies, and that they guide their practice because of evidence-based research.  However, they also indicated that while they do understand the clinical significance of end-tidal capnography, they have not received adequate training on the subject.  

Conclusion: The research project answered the research question of what are the perceived barriers that registered nurses in a rural Pennsylvanian hospital have to the utilization of end-tidal capnography?  The data that was collected indicated that the nurses in the study hospital expressed a learning deficit related to the theory of capnography and the impact it has in patient care, and a lack of knowledge related to the proper use of the capnography equipment available at the study hospital.  However, the difference in data with the participants expressing that the majority understands the clinical significance of end-tidal capnography requires further study to determine the perceived learning deficits the nurses have.  The research project has the potential to influence evidence-based nursing practice regarding the use of capnography in patients with respiratory difficulty in this acute care hospital.