Factors Affecting Validity of Arterial Blood Gases Results among Critically Ill Patients: Nursing Perspectives

Abstract

Arterial blood gases  sampling is one of the most common laboratory tests in intensive care units and   might be corrupted by pre-analytical factors that influence the validity of results. Arterial blood gases are valuable only if obtained properly and measured carefully. Corrupted factors in arterial blood gas sampling change significantly the results and adversely affect patient-care decisions when the magnitude of the error is clinically important  .Therefore the nurses’ role is very important to control these factors. The aim of this study is to assess the different pre- analytical factors affecting ABGs results’ validity among critically ill patients at Cairo University Hospitals. The following research questions were formulated Q1: What do critical care nurses know about the different factors that can affect ABG results’ validity? , Q2: What are the different practices performed by critical care nurses in relation to ABG results’ validity?  And Q3: What are the additional pre-analytical factors that might affect the ABG results?. A descriptive exploratory research design was utilized in this study.  A sample of convenience of 68 bed side nurses were recruited from three  intensive care units affiliated to Cairo University Hospitals which are; Surgical ICU, medical ICU , and Neurological ICU.  Three tools were utilized to collect data; ABGs nurses’ knowledge questionnaire that consists of two sections, the first section included Socio-demographic data and  the second section constituted 17 questions that covered factors affecting ABGs’ results, ABG withdrawal technique, and indications, and complications of sampling related questions. The second tool was ABGs observational checklist including arterial sampling practices through two main different methods; direct puncturing from radial or femoral sites   and indirect puncturing from arterial line and finally assessment of pre-analytical factors that may affect validity of ABG results. Findings of the study showed that the all the studied subjects (100%) demonstrated unsatisfactory knowledge and practical level in relation to ABG sampling and controlling the different factors that might affect ABG results’ validity.  Moreover, There were no significant statistical difference between knowledge scores   regarding educational level (F=2.73; P=0.07), working area (F=1.07;P=0.34), and gender (F=1.096;P=0.29) among the studied subjects. Results of the current study indicated a real gap between nurses' knowledge and practices as compared to the evidence based guidelines of American Association for Respiratory Care in management of ABG sampling. The current study recommends an enrichment of critical care nurses’ knowledge and practices related to this essential procedure in addition to consideration of the different corrupting factors by hospital authorities to keep with the related evidence based guide lines that will be great benefits for patient, hospital, and all health professionals.

Key words: validity of Arterial blood gases' results, pre-analytical factors affecting.