Current state and influencing factors in airbag management among emergency department nurses: A multicenter study

Abstract

BACKGROUND

The emergency department (ED) plays a critical role in establishing artificial airways and implementing mechanical ventilation. Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia. Nonetheless, existing research has largely overlooked the understanding, beliefs, and practical dimensions of airway airbag management among ED nurses, with a predominant focus on intensive care unit nurses.

AIM

To investigate the current status of ED nurses' knowledge, beliefs, and practical behaviors in airway airbag management and their influencing factors.

METHODS

A survey was conducted from July 10^th to August 10^th, 2023, using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai. Pathway analysis was utilized to analyze the influencing factors.

RESULTS

The scores for ED nurses' airway airbag management knowledge were 60.26 ± 23.00, belief was 88.65 ± 13.36, and behavior was 75.10 ± 19.84. The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training, department, and work experience in the department. Influencing factors of airbag management belief comprised knowledge, department, and participation in specialized nurse or mechanical ventilation training. Primary influencing factors of airbag management behavior included knowledge, belief, department, participation in specialized nurse or mechanical ventilation training, and professional title. The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior, with a total effect value of 0.513, and an indirect effect of 0.085, constituting 16.6% of the total effect.

CONCLUSION

ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices, yet there remains room for improvement in their knowledge levels. Nursing managers should implement interventions tailored to the characteristics of ED nurses' airbag management knowledge, beliefs, and practices to enhance their airbag management proficiency.

Keywords: Artificial airway management; Health knowledge; Attitudes; Practice; Airbag management; Pathway analysis; Nurses

Core Tip: The emergency department (ED) serves as a critical setting for establishing artificial airways and implementing mechanical ventilation. Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia. Research findings reveal that ED nurses generally harbor a positive attitude toward airbag management, and their practical behaviors are moderately standardized. Nevertheless, there remains a need for enhancing their knowledge levels. This study offers theoretical underpinning for delivering pertinent training and fostering the development of specialized nursing programs tailored to ED settings. Furthermore, it underscores the necessity for implementing targeted improvement strategies.