Suctioning a patient's airway is a standard intervention used frequently by nurses internationally. Acute care patients who are mechanically ventilated require suctioning multiple times a day to remove secretions and to prevent ventilator associated pneumonia (VAP), which is a costly and life-threatening complication. The nurse expects the suction equipment to appropriately and accurately function. A practice assumption is that the suction gauge reading is the actual inline suction pressure measurement. A comprehensive literature review and synthesis was conducted to identify the evidence surrounding common suction practices.

Method

A metasynthesis of the literature related to suction practices was performed. Initial knowledge of suction studies and VAP related research facilitated the identification of the appropriate keywords, journals, and databases to review in this metasynthesis. A detailed methodology was developed, and specific key words in peer-reviewed journals from selected health related databases guided the thorough literature review. Computer software was used to manage references in this comprehensive literature review. The articles were reviewed, analyzed, and synthesized to identify the evidence in similarities and differences in suction practices.

Results

The detailed procedure of conducting the metasynthesis validated the lack of research based evidence related to verifying suction accuracy by measuring inline suction pressure. Suction gauge readings are not compared with inline suction measurements; thus, the actual suction pressure needed to remove secretions is not known.

Application to Practice

Nurses currently provide suction intervention without having a clear knowledge of inline suction pressure being applied at the tissue level, which inadvertently may result in negative outcomes. Further studies are needed to describe the pressure difference between inline suction pressure measurements and suction gauge readings to direct evidenced-based practice decisions and positive nursing outcomes. Optimal suction procedures are needed to provide safe and effective care to acute care populations.