Assessing Anesthesia Providers’ Perceptions of Adequacy of Endotracheal Tube Cuff Pressure Assessment Techniques: A Doctor of Nursing Practice Project

Abstract

Endotracheal tube cuff pressure management is an important patient care intervention within the intraoperative setting. Current management practices include several subjective measurement methods as well as an objective manometer device. Due to a lack of consensus, there is no standardized method of assessing endotracheal tube cuff pressures used within the clinical setting today. The purpose of this quality improvement project was to assess anesthesia providers’ perceptions of perioperative usefulness of subjective and objective assessment for obtaining adequate endotracheal tube cuff pressures. Current literature favors the manometer device and suggests there are negative implications with the use of subjective endotracheal tube cuff pressure measurement techniques. A video summarizing this currently available evidence was shared with the participating providers of this quality improvement project. Manometer devices were directly provided to the participating CRNAs for use, allowing them to make informed opinions on the perioperative usefulness of an objective manometer device as well as the subjective measurement methods they generally used. The purpose of this quality improvement initiative was to better understand anesthesia providers’ perceptions of the available endotracheal tube cuff pressure management practices. Upon conclusion of the project implementation period, perceptions regarding subjective assessment of ETT cuff pressures shifted towards feelings of inadequacy as well as neutrality. In opposite fashion, opinions regarding the manometer device shifted towards a consensus of greater perceived adequacy. Furthermore, a planned change of behaviors was noted as the intent to use a manometer in the future increased among the majority of the participating CRNAs.