Nurses' and Families' Experiences of a Feasibility Trial Comparing Single-Use and Multiple-Use Endotracheal Suction Catheters in Mechanically Ventilated Patients: A Qualitative Study.

Abstract

In resource-limited Intensive Care Units (ICUs), reusing endotracheal suctioning catheters is often standard practice due to supply constraints or staffing pressures. Randomised controlled trials (RCTs) have explored the impact of these practices on patient outcomes. However, less is known about the experiences of nurses and family members involved in RCTs testing endotracheal suctioning interventions. To explore the experiences of ICU nurses and family members participating in a feasibility RCT comparing single-use versus multiple-use endotracheal suction catheters flushed with chlorhexidine or normal saline in a resource-limited ICU setting. A qualitative study was embedded within a feasibility RCT. Semi-structured interviews were conducted with 13 ICU nurses and seven family members at a university hospital in Egypt. Data were audio-recorded, transcribed verbatim, and analysed using Thematic Analysis supported by NVivo software. Five themes were identified: (1) Navigating resource limitations in daily practice, (2) Building knowledge and confidence in intervention delivery, (3) Balancing infection control with feasibility, (4) Families navigating through emotional and cultural uncertainties, and (5) Family perceptions of trial participation and consent. Nurses valued structured training, which enhanced adherence and confidence, but expressed concerns about budget and supply constraints. Families appreciated clear explanations of interventions and valued the potential to improve patient safety, though some reported anxiety around unfamiliar procedures. Both nurses and family considered the interventions and trial procedures acceptable and feasible within the ICU context, although long-term implementation may require addressing resources and training needs for ICU nurses. Understanding the experiences of delivering interventions by nurses and the involvement of family in clinical trials is essential for designing RCTs testing novel nursing interventions. These insights can inform future large-scale RCTs testing endotracheal suction catheters interventions in mechanically ventilated patients and ensure trial successes. ClinicalTrials.gov, identifier NCT06207513.