Suctioning: Oral and Nasal
Prerequisite Skills
Respiratory assessment, sterile technique
Critical Element Criteria
Students must meet criteria of Critical Elements to safely perform the skill based on evidence-based practice. Score can be pass/fail, letter grade, or point assignment. Only acceptable score for Critical Elements is 100%
Critical Elements
- Maintain sterile technique throughout.
- Perform hand hygiene before and after procedure.
- Educate patient of the procedure.
- Apply suction no longer than 15 seconds.
- Perform procedure safely for patient.
Procedure
Prior to Treatment: (Critical Thinking)
- Assess patients need for treatment.
- Confirm order.
- Gather equipment: face shield or goggles and gown, wall suction or portable suction, gloves, suction catheter, sterile saline.
Patient Interaction: (Safety)
- Patient identifiers.
- Provide for privacy.
- Explain procedure.
- Wash hands.
Steps of the Procedure (Patient Centered Care; Safety, Infection Control)
- Place patient in a semi-fowler"s position with head turned facing the nurse.
- Place linen saver pad or towel on patient"s chest.
- Apply personal protective equipment.
- Turn on suction and adjust pressure according to agency policy.
- Apply procedure glove and test the suction by occluding the connection tubing, discard glove, and wash hands.
- Open the suction catheter kit.
- Apply sterile gloves, keeping dominant hand sterile.
- Pour sterile saline into containers with nondominant hand.
- Grab sterile catheter with sterile hand and place onto suction tubing without contaminating.
- Place catheter in sterile water, moistening.
- Use nondominant hand, removing oxygen, if present.
- Insert the suctions catheter along the side of the patient"s mouth into the oropharynx or through the nose to the nasopharynx area.
- Advance the suction catheter with inspiration, do not force the catheter.
- Place a thumb over the suction control port of the catheter, apply suction while withdrawing the catheter, using a continuous motion.
- Apply suction no longer than 15 seconds.
- Withdraw the catheter, placing the tip in the sterile water and clearing the tubing.
- Repeat as needed.
- Clear the tubing by suctioning the remaining water.
- Dispose of equipment properly.
- Assess respiratory status.
After Procedure (Patient Centered Care, Safety)
- Straighten room making patient comfortable, replace call light.
- Wash hands before leaving room.
Documentation (Informatics, Communication)
- Amount and color of sputum.
- Patient"s response to procedure including respiratory assessment.