and medical staffs’ attitude through interviews
[23]. Open questions were also used since they
embrace a wide range of problems caused by
not utilizing closed suction in addition to the
solutions for them. At this point, there was a
significant difference between the verbal
responses of personnel about using suction and
answers gathered through the questionnaire.
Determining the priority of problems and
solutions after listing them, the charge nurse
and supervisor’s comments were used. One of
the problems with prioritizing solutions was
that some of them, considering their top rating,
were not applicable due to their high cost and
unavailability of facilities. In planning stage,
after choosing the best solution, a meeting was
arranged with the hospital manager, its charge
nurse, supervisor of intensive care unit, and
educational supervisor about the applicability of
solutions. One of the offered solutions was
increasing the suction power which was
discussed in the study of Losaki [20] and John
Smith [24]. This solution required replacing
central suctions, about which the headmaster
was consulted with. Because of the availability
of the device in the storage room of the
hospital, three central suction devices were
installed to be piloted. When the devices proved
to be efficient, the results were reported to the
hospital management and other machines were
also installed in the unit.
To apply the suggested solutions, different
techniques, such as sensitization, were
primarily utilized [21]. Regarding educational
messages hung on ICU walls about suction, the
staff was sensitized and motivated about using
CSS. The staff was also continuously and
clinically trained about the issue. One of the
problems was that some of the personnel could
not share their knowledge with others. To solve
this problem, different nurses working in
various shifts were utilized. Additionally, to
make the training more effective, the technique
of feedback [22] was used in different stages of
suction. The questionnaire was again used for
evaluation stage and it was asserted that using
action research increases the nursing staffs’
tendency. The results obtained from the present
study accord with those of Chao et al. (2007)
which was conducted to reduce the side effects
of suction in patients of ICU. In their study,
implementing the solutions was found practical
and reduced the side effects. They noted that it
is important for nurses to be able to perform a
safe procedure and act according to the
research-wise suggestion. This article presented
the process of improvement, expansion, and
implementation of the best suction instruction
and investigated the procedure and results of
taking care of patients while and after suction in
ICU. It proved that utilizing action research
reduces suction side effects [25].
Prat et al. (2001) applied action research
method and doctors and nurses’ participation to
change their attitude and improve their
functioning while taking care of AIDS patients.
The results showed that applying this method
changed the staff’s opinion toward AIDS
patients [23].
5. Conclusion
Conducting an action research is an apt method
to change and improve nurses’ functioning
since in this method asking the staff’s ideas and
making them participate in the study makes
changes happen faster and decisions more
stable and acceptable among nurses. In the
present study, presenting solutions by the
staff’s participation augmented their tendency
in using CSS in ICUs.
6. Acknowledgments
We warmly appreciate the efforts of the
hospital manager, charge nurses of ICU, and the
nursing staff who assisted us in this study with
collecting the data and running the program.