Although endotracheal suctioning (ETS) is essential, the procedure, however, is not free of
risks and complications especially when performed incorrectly. These risks and complications can
seriously affect the stability of critically ill patients. Therefore, it is very important to perform this
procedure with professional competence, which means not only having the necessary skills, but also
knowledge based on recent scientific evidence, and ensures efficiency and the safety of the patient.
The aim of this study is to evaluate the gap between knowledge and practice in open system ETS
among critical care nurses (CCNs). Methodology: Sixty CCNs working at the Intensive Care Units
(ICUs) of Alexandria Main University Hospital ( AMUH) and providing direct care for patients
with an artificial airway were included in the study. Two different tools were used to collect the
data; Endotracheal suctioning knowledge 'structured questionnaire, and Endotracheal suction
observational checklist. Results: more than two thirds of the study sample were female, and had
bachelor degree either intern or staff nurses. 63.3 % of them had working experience of less than 5
years. Knowledge of CCNs regarding ETS was higher than their performance. Conclusion &
recommendations: it can be concluded that CCNs had inadequate knowledge and poor
performance in relation to ETS and there was a gap between knowledge and practice of CCNs in
relation to ETS. These findings suggest that CCNs should be continuously assessed for their
knowledge and practices regarding ETS and CCNs' performance in relation to ETS should be
improved. In service educational programs should be conducted for critical care nurses regarding
ETS.