Knowledge, Attitude, and Practice of Artificial Airway Suctioning among Nursing Interns in Intensive Care Units of Tertiary Care Hospitals in Peshawar, Pakistan

Abstract

Background: Artificial airway suctioning is a fundamental procedure in intensive care units (ICUs), essential for maintaining airway patency, preventing pulmonary complications, and improving oxygenation. However, improper suctioning technique can lead to adverse outcomes such as hypoxia, mucosal injury, infection, and cardiac arrhythmias. Despite established evidence-based guidelines, global studies consistently report inadequate knowledge and poor adherence to recommended suctioning practices among nurses. Limited research in Pakistan has highlighted substantial gaps in theoretical understanding, clinical execution, and attitudinal readiness, particularly among nursing interns who represent the frontline workforce in critical care settings. Objective: This study aimed to assess the knowledge, attitude, and practice (KAP) of artificial airway suctioning among nursing interns in tertiary care ICUs in Peshawar, Pakistan, and to examine associations with demographic factors and interrelationships among KAP domains. Methods: A cross-sectional descriptive study was conducted from February to August 2024 in ICUs of three tertiary hospitals. A total of 117 nursing interns were recruited via convenience sampling. Data were collected using a validated self-administered questionnaire assessing knowledge (15 items), attitude (10 Likert-scale items), and self-reported practice (10 items). Descriptive statistics, Chi-square tests, and Pearson correlation analyses were performed to explore associations and relationships among variables. Results: The mean knowledge score was 9.86 ± 2.03, with 41% demonstrating good knowledge. Positive attitudes were reported by 42.7%, and 42.7% showed good practice. Formal training was significantly associated with higher knowledge (p = 0.002) and better practice (p = 0.001), while longer internship duration correlated with improved knowledge (p = 0.035). Knowledge correlated moderately with practice (r = 0.42, p < 0.001) and weakly with attitude (r = 0.25, p = 0.010). Conclusion: Nursing interns exhibited moderate knowledge and variable practice regarding artificial airway suctioning, with predominantly neutral attitudes. Formal training and clinical exposure significantly improved competency levels. Strengthening curricula, integrating simulation-based learning, and fostering positive attitudes are critical to enhancing clinical performance and patient safety.