Change the world

School of Clinical Care Sciences

RESEARCHER: Mpasa, F

ABSTRACT: Endotracheal tube cuff pressure (ETT cuff pressure) management in mechanically ventilated adult patients is not properly done in most intensive care units in Malawi. Poor management of ET cuff pressure puts the mechanically ventilated patients under risk of tracheal injury which can be caused by over or under inflation of the ET cuff. While over inflation can lead to occlusion of capillaries lining the trachea at the cuff site, leading to death of mucus membranes around the area, under inflation can lead to air leaks as well as aspiration of gastric contents into the tracheal tree. This study will focus on utilization of active and passive clinical practice guideline implementation strategies in the implementation of a clinical practice guideline for management of ETT cuff pressure in mechanically ventilated adult patients in the ICUs in Malawi.

An experimental design will be used in a four phase approach for management of ETT cuff pressure utilizing active and passive implementation strategies. Phase one will involve the reviewing of current practices related to ETT cuff management; phase 2 will be contextualize an existing guideline for management of ETT cuff; phase 3 will implement the existing guideline utilizing active and passive clinical practice guideline implementation strategies and phase 4 will involve the evaluation of the effect of the active and passive implementation strategies on the management of ETT cuff pressure in the ICUs in Malawi. The six ICUs selected will be randomly allocated to active and passive groups. The research study will produce robust evidence which will inform effective practices related to management of ETT cuff pressure in the ICUs in Malawi.