# Enhancing Clinical Practice in Adult Airway Suctioning: A Two-Cycle Audit at Aswan University Hospital

## TL;DR

This study shows that education and training improved healthcare workers' adherence to proper airway suctioning techniques in a hospital setting.

## Contribution

A two-cycle audit and educational intervention improved clinical practice in adult airway suctioning at Aswan University Hospital.

## Key findings

- Recognition of suctioning indications improved from 23% to 72.8% after the intervention.
- Post-suctioning procedures adherence increased from 20% to 80%.
- Awareness of special considerations rose from 25% to 75%.

## Abstract

Background: Endotracheal suctioning (ETS) is a critical intervention for mechanically ventilated adult patients in intensive care units (ICUs), but improper technique can lead to significant complications. Adherence to established ETS guidelines is essential for patient safety and optimal outcomes. The aim of this study is to assess and improve healthcare professionals’ adherence to adult airway suctioning guidelines at Aswan University Hospital through a two-cycle clinical audit and targeted educational intervention.

Methods: A cross-sectional audit was conducted in the ICU, Emergency Department, and Short Stay Rooms at Aswan University Hospital. In the first cycle, 103 healthcare workers were evaluated for adherence to ETS protocols using a standardized questionnaire. Root causes of non-compliance were identified, followed by an educational intervention including didactic sessions, hands-on training, and protocol reinforcement. The second cycle involved 125 participants and reassessed adherence post-intervention.

Results: The educational intervention led to notable improvements in guideline adherence. Recognition of suctioning indications improved from 24 (23%) in the first cycle to 91 (72.8%) in the second. Performance of post-suctioning procedures rose from 21 (20%) to 100 (80%). Awareness of special considerations increased from 26 (25%) to 94 (75%). Moderate gains were also seen in suction duration, catheter selection, and complication awareness. However, documentation and equipment selection showed only modest improvement or minor decline, indicating the need for continued education.

Conclusion: Targeted education and protocol reinforcement significantly improved most aspects of airway suctioning practice among healthcare workers. Sustained improvements require ongoing training, regular audits, and a focus on practical skills, particularly in documentation and equipment selection.