Knowledge and current practices of ICU nurses regarding aerosol therapy for patients treated with invasive mechanical ventilation: a nationwide cross-sectional study.

BACKGROUND Aerosol therapy is a routine operation for intensive care unit (ICU) nurses; however, evidence of the knowledge and current practices of ICU nurses regarding aerosol therapy for patients with invasive mechanical ventilation is insufficient in China. OBJECTIVE This study aimed to determine the knowledge and current practices of ICU nurses regarding aerosol therapy for patients with invasive mechanical ventilation in China. SETTING A total of 433 hospitals in 92 cities (including 31 capital cities) in 31 provinces in China participated in the study. METHODS A questionnaire was used to investigate the knowledge and current practices of ICU nurses regarding aerosol therapy for patients treated with invasive mechanical ventilation, including 42 questions covering five aspects: sociodemographic information, aerosolization devices, atomised drugs, atomisation operation, and atomisation-related knowledge. Descriptive analyses of the distribution of the sample are reported as percentages and medians. Univariate and multivariate analysis was used to detect the factors of the interviewee's atomisation knowledge and practices scores. A STROBE checklist was used to guide the reporting of the research. RESULTS Of the 1,995 questionnaires that were returned, 1,978 were analysed. Bronchodilators and glucocorticoids were the most frequently administered drugs. Seventy-four percent of the total respondents reported placing a filter on the expiratory limb during aerosol therapy, and 47% of these reported that the filter was changed once a day. Only 13% of the respondents reported always turning the heating humidifier off during aerosol therapy, and 48% never did. Knowledge about the optimal droplet size or atomisation yield was poor. Work experience in the ICU and frequency of atomisation training were the independent influencing factors for atomisation knowledge and practice scores (F=279.653, P<0.001; F=120.556, P<0.001, respectively). CONCLUSIONS The knowledge of ICU nurses about the optimal implementation of aerosol therapy is poor, and the current scientific knowledge about optimal implementation seemed to be applied infrequently. Atomisation-related training should be strengthened, especially for nurses with junior titles and with less work experience. RELEVANCE TO CLINICAL PRACTICE Improving the level of ICU nurses' atomization practice ability is helpful to ensure patient safety. In clinical work, atomization expert consensus can be used to carry out relevant training and standardize atomization operation.