Study On The Effect Of Green Model To Promote The Management Of Endotracheal Tube Cuffs In ICU Nurses

Objective:The aim of this study is to assess the current knowledge,attitudes and behaviour of ICU nurses in the management of endotracheal tube cuffs in the artificial airway and their educational and training needs using the Green model as a theoretical framework and a self-designed questionnaire system.Based on the results of the questionnaire,the main problems of nurses in endotracheal tube cuffs management were analyzed,and an intervention and training plan was developed and evaluated according to the causes,so as to improve the knowledge and behavioural compliance of ICU nurses in endotracheal tube cuffs management,reduce unnecessary harm to patients caused by poor cuffs management and further ensure patient safety.Method:1.Designing the questionnaire: Reviewing the literature,constructing the first draft of the questionnaire and completing the reliability test based on the Green model as the theoretical basis.2.Baseline survey: Using the designed questionnaire,a total of 371 ICU nurses from eight tertiary general hospitals in Shanxi Province were surveyed to understand the current status of nurses’ knowledge,attitudes and behaviours in cuff management of the artificial airway and the current status of education and training they received on cuff management and their needs.3.Intervention study: A convenience sampling method was used to select 2 of the tertiary general hospitals in Shanxi Province.According to the principle of whole-group sampling,35 nurses from the neurosurgical ICU of one of the hospitals who met the inclusion and exclusion criteria were selected as the intervention group to receive the intervention training programme based on the Greene model,and 33 nurses from the neurosurgical ICU of the other hospital who met the inclusion and exclusion criteria were selected as the control group to receive the routine practice study.The ICU nurses’ knowledge,attitude and behavioural questionnaire scores,knowledge paper scores and implementation rates of various measures of airbag management were compared between the two groups before,one month after and two months after the intervention using the "ICU nurses’ knowledge and behavioural questionnaire on artificial airway cuff management","knowledge paper on artificial airway airbag management" and "cuff management assessment and practice questionnaire",respectively.The comparisons were made to evaluate the effectiveness of the Green model in the management of artificial airway cuffs by ICU nurses.Results:1.The 371 ICU nurses scored a minimum of 2 and a maximum of 15 on the knowledge section of cuffs management,with a mean score of(7.04±2.715)and a pass rate of 28.03%.In particular,the nurses lacked knowledge of airbag materials,shapes,cuff inflation methods,methods of determining air leakage and timing of pressure measurement.The lowest score for the attitude section was 27 and the highest score was 45,with an average score of(38.09 ± 4.973)and a pass rate of100%;the lowest score for the behaviour section was 14 and the highest score was 70,with an average score of(45.25±7.710)and a pass rate of 61.46%.2.Nearly 19.14% of ICU nurses had not received training in airbag management knowledge,22.91% had attended one training session,and 18.06% and 39.89% had attended two,three or more sessions respectively.Thankfully,the percentage of nurses who said they were willing to attend training and education on endotracheal tube cuffs management was 97.04%,with only 2.9% of nurses not willing to attend relevant training and education.3.After the intervention,nurses’ endotracheal tube cuffs management knowledge-trust-behaviour questionnaire scores,knowledge examination paper scores and implementation rates of cuffs management measures improved in both groups compared with those before the intervention,and nurses’ airbag management knowledge scores,attitude scores,behavioural scores,knowledge examination paper scores and behavioural compliance improved better in the intervention group than in the control group,and the difference between the two groups was statistically significant(p < 0.05).Conclusion:1.Nurses in Shanxi Province lack knowledge related to airbag management of artificial airways,mainly in the areas of airbag process management,airbag pressure measurement,inflation and methods of determining air leakage.The attitude towards airbag management is relatively positive,but the behavioural compliance of airbag management is poor.The poor compliance is mainly reflected in the poor implementation of various measures of airbag management.2.Both the training model of cuff management intervention under the guidance of Green model and the routine business learning can improve the nurses’ cognitive implementation ability of airbag management to varying degrees,but the former is significantly more effective than the latter,and can be further promoted and applied to the continuing nursing education.