Nurses' Knowledge, Skills, and Practice in Endotracheal Tube Cuff Management

Abstract

Introduction: Endotracheal intubation is a critical skill for securing the airway in critically ill patients, while maintaining adequate pressure in the endotracheal tube cuff prevents aspiration and ensures effective ventilation. Insufficient or excessive cuff pressure can cause serious tracheal injury and other complications, making it essential for nurses and technicians to follow standardized guidelines and protocols for optimal cuff management.

 Aim: To evaluate the knowledge, skills, and practice of nurses in managing the endotracheal tube cuff.

 Materials and Methods: The study was conducted at the Clinical Center of Vojvodina in January 2025, with a five-working-day period for questionnaire completion. Thirty-two nurses (N = 32) working in intensive care units and/or operating rooms participated. A self-designed 23-item questionnaire was used, divided into general characteristics, assessment of knowledge, skills, and practice related to endotracheal tube cuff management. Fourteen items were scored: ten assessing knowledge, three assessing skills, and one assessing practice (correct answer = 1, incorrect = 0); the remaining items were descriptive. Total scores ranged from 0 to 14 and were expressed as percentages. A score ≥ 50% indicated a satisfactory response in all three domains, while a score ≤ 50% indicated an unsatisfactory response.

 Results: Nurses demonstrated satisfactory knowledge and practice but weaker skills in managing the endotracheal tube cuff, indicating a discrepancy between theoretical knowledge and practical abilities. The average percentage of correct answers was 61.4%, with the highest score being 85.7%. A score above 50% was achieved by 75% (N = 24) of nurses. Experience was found to contribute to the development of knowledge and skills.

 Conclusion: While theoretical knowledge was satisfactory, practical skills in endotracheal tube cuff management were insufficiently developed. The results highlight the importance of continuous education and practical training to improve the quality of care and the safety of intubated patients.