The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts


- Anne Schaer, RRT, Tim Frymyer, BS, RRT, David Mussetter, BA, RRT, Michael Trevino, MS, RRT, Gary Weinstein, MD, FCCP, Presbyterian Hospital of Dallas, Dallas, Texas.

BACKGROUND: In-line suction catheters are widely used in the adult intensive care setting, with few varieties of catheter choices available. Historically, our institution has used the Kimberly-Clarkä/Ballardä Adult Trach Careä in-line suction catheter, which has performed well and met our needs. In an effort to gain a potential cost savings and minimize incidents of breaking the ventilator circuit, our 903-bed metropolitan teaching hospital evaluated the BARDÒ Respishieldä with InnoValveä closed suction system catheter. We hoped to determine the suitability of this catheter as a replacement.

METHOD: Nursing and the respiratory therapy staff were in-serviced by the vendor representative. The Respishield catheter was placed in all 4 of our adult intensive care units (31-beds). All patients receiving mechanical ventilation via an artificial airway were converted to the RespiShield catheter. During the evaluation period, we utilized 36 new catheters and 15 detachable replacement catheters. A product evaluation tool was created using a Likert scale. This questionnaire was given to those respiratory therapists and nurses who were using the new catheter. The evaluation questions specifically covered the unique aspects and performance of the new catheter.

RESULTS: The product evaluation forms were collected and the results are listed below. During the evaluation period we had one instance in which a suction catheter tip was sheered off. No patient complications resulted from this incident; however, the product evaluation was terminated.

Question Score Recommendations
The swivel adaptor reduces tension on the patient's airway. 83% Agree Keep the swivel adaptor
The InnoValve has prevented the suction catheter from being lodged in the patient's airway. 51% Agree Design so catheter tip cannot be sheered by the InnoValve
You can give an effective in-line therapy with the Bard in-line catheter. 100% Disagree Change elbow to universal diameter
There are fewer breaks in the circuit with the Bard In-line catheter. 50% Agree Keep configuration to reduce breaks in circuit
The large adjacent eyelets on the suction catheter provides efficient vacuum to remove thick secretions. 58% Agree Stagger eyelets to prevent weak point
Do you see a benefit in changing from the current Ballard catheter to the Bard RespiShield? 75% Disagree More changes are required

CONCLUSION: A successful product evaluation does not always result in the purchase or denial of a new product into your institution. Hospitals and vendors must collaborate to improve the quality of products used in healthcare. This was evident in our evaluation of the Bard RespiShield catheter. All the information gathered by the staff was shared with Bard, who was very interested in our clinical input. Bard reported to us they had made significant changes to their product, as a result of our feedback. At this time, we have elected to stay with the Ballard in-line suction catheter, based upon review of the staff's experiences and product evaluations.