Download TRAIN THE TRAINER Suction and Oxygen

Suction, Oxygen and Saturation
Monitoring
Leanne Turner
Carol Lawrence
Mandy Parker
&
Why are we doing this training
• Liverpool long term suction pathway
• Audit results
Issues with schools training
Issues with equality of training
Issues with machine maintenance
Issues with maintenance training
Issues with retraining
Issues with poor technique
• Care Plans
Impact on the child and family!!!
What will be covered today
• Professional responsibility
• Learning styles
• Teaching Suction- Training Pathway, package for
training, assessment, good technique and suction
maintenance
• Teaching Oxygen- Training Pathway, Package for
training, assessment
• Teaching saturation monitoring
• OSCE assessment
Suction
Teaching and assessment pathways
• NP suction
• Oral suction
• General Oral Suction/Oxygen
training for school staff
Look at the Suction plan
When do I need suction?
When you can hear and feel
secretions and I’m distressed by
them
When my saturations are low
When I’m working harder with my
breathing
When I’m coughing but not clearing
secretions
How can you make suctioning
easier for me?
Explain to me what you are doing
Talk to me as you do it so I know it is
nearly over
How do I get suctioned?
Suction pressure– 150mmHg/ 20KPa
I am suctioned via my tracheostomy.
I use size 10 suction catheters down
to a depth of 7.5. I sometimes require
suction in my nose or mouth
How often do I get suctioned
when I’m well?
This is vary variable as every day is
different but if I’m unwell my
secretions change in colour and are
thicker
What are my secretions like
when I’m well?
Loose white/clear secretions
What machines can be used
and where are they stored?
Sam 12 - at home
De Vilbiss - portable
Contacts for suctioning
BME Alder Hey– Machine
maintenance
Telephone– 01512525293
Community nurses–
Consumables/Training
Telephone– 01512933593
Community respiratory
Physiotherapist
Telephone– 07824547864
Suction assessments
and Care Plans
• Plans to reduce risk and effectiveness of
technique
• Community respiratory physiotherapy team
• Suction and oxygen assessment
• Joint care planning with Oxygen nurse specialist
• Oxygen and Suction care plan
This means:Clear guidance for people teaching
Child specific needs identified to personalise
teaching
Stage 1 Training
Suction awareness session
• Overview of anatomy
• Indications
• Hazards
• Respiratory Assessment
• Pressure setting
• Technique
• Practice of technique
• Machine maintenance including consumables
STANDARDISED TEACHING PACKAGE NP & ORAL
Presentation, Workbook (if required), OSCE & Competency Ax
SUCTION MAINTAINENCE CHECKLIST STANDARD FOR BOTH
Stage 2 Training
Mentoring of practice
• Monitoring
• Questioning/Challenging
• Correcting technique and improve knowledge
• Preparation for assessment using competency
framework and OSCE as a guide
Assessment
• Suction competency framework- NP/Oral
• Practical Ax- OSCE assessment- NP/Oral
• COMPETENT VS GOOD QUALITY.
We want good quality as this improves the
child’s outcomes!!!!!!!!!!
What does good technique look like?
Common areas to look out for
•
•
•
•
•
Hand washing
No child preparation
Depth
Incorrect size catheter
Repetitive catheter use
•
•
•
•
•
Speed-NP
Contamination
Catheter at nose-NP
Pressure
Blind sweeping-Oral
Suction Maintenance
•
•
•
•
•
Checklist
Different Machines
CQC
Servicing
Set ups- New equipment- new lids
Current
New
Incidents with new lids
• Child without suction machine all day in
school
• Child on holiday without suction machine for
4 days
• 2 children unable to set up and use machine
on delivery of consumables
Training Issue
Consumables.
Where do you get them-CCNT/GP
How to store them- yankauer cover,
catheters no pre attachment and avoid
bending
Bending catheters make
them hard to use
Cover for infection
control
Wallace Tubing- change Weekly
Filter- change 3 monthly
Suction catheters- change after each use
Can use twice NP but
must not touch anything
in between. Never Mouth
to Nose and avoid nose to
mouth
Yankauers- change daily
Spares required to go into
school/Respite/Out and about
Incase broken/ dropped
Machine.
Power light indicator.
Battery Charger/Car Charger-Importance of
going out- no red.
Checking power/Charging.
Checking suction pressure- finger over end
or kinking tube
Adjusting suction pressure.
Leave on charge before
going out
red light always flicks on
when switched on but
most not stay on
Kinking tube handy for
yankauer as no need to
disconnect. Also infection
control
Do not press in the button
just turn it otherwise it
effects setting accuracy
Ideal Pressure- 20KPa/150-160mmHg.check and recheck
Places where it might break (lid, right angle
cold weather, tubing)
Who to call if your machine is brokenBME/Community Equipment Stores/ CCNT
label will indicate who to
ask. BME never in weekend
so CCNT then
Cleaning.
Bag- 40 degree washing machine.
Machine- wipe down warm soapy water
Canister-full clean daily. New collection
bottles do not wash filter connector. Empty
when more than half full
After use flushing- tap water.
no excessive water just
damp cloth. Care with
filters as if wet or damp
wont work
Never wash filters new or
old system
Empty more than half full
as will effect pressure if
nearly full. Especially
important when going out
sterile water no longer
required.
Yearly update
• OSCE and Competency framework
• Suction Maintenance Checklist
• Retraining with identified training plan for
individual after reassessment if not achieving
competency