Assessing Anesthesia Providers’ Preferences and Perceptions of Adequacy of Endotracheal Tube Cuff Pressure Assessment Techniques: A Quality Improvement Project

Abstract

This Doctor of Nursing Practice project assessed CRNA preferences and perceptions of adequacy regarding subjective versus objective methods to assess endotracheal tube cuff pressure. The ideal pressure within an endotracheal tube cuff is approximately 20-30 cm H2O. Pressure from the cuff is transferred to the surrounding tracheal mucosa and both inadequate and excessive pressures can lead to medical complications. Subjective methods, such as pilot balloon palpation, minimal occlusive volume, leak test, and a set volume, are generally less accurate than objective measurement with a manometer for the achievement of appropriate endotracheal tube cuff pressure. Seven total CRNA participants at an outpatient surgical center were provided manometers and a brief informational video on cuff pressure and how to use the provided manometers. They reported using the manometers between zero and 20 times during the two-week intervention period. Survey results indicated most participants perceived both subjective and objective methods as adequate for obtaining appropriate endotracheal tube cuff pressure. Pre- and post-intervention survey results also indicated that most participants used solely subjective assessment methods prior to the intervention and will continue to do so after the two-week intervention period.