Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation

Kwon, RN EunOk; Choi, RN KyungSook

doi:10.1016/j.anr.2017.03.004

Cited by 19 publications

(39 citation statements)

References 21 publications

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“…( 3 ) More recent studies cite a lower incidence of UE, such as a center in Korea reporting UE occurring at a rate of 0.6%. ( 4 ) Unplanned extubation is considered to be an indicator of quality of care for critically ill patients ( 5 ) as it is associated with increased morbidity, mortality and cost in a majority of studies on UE. ( 6-8 ) However, there could be variations between centers, as some reported not having an increased mortality risk.…”

Section: Introductionmentioning

confidence: 99%

Incidence, risk factors, and outcomes of unplanned extubation in adult patients in a resource-limited teaching hospital in the Philippines: a cohort study

Uy¹,

Ramos²,

Rivera³

et al. 2019

Revista Brasileira De Terapia Intensiva

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Objective We aimed to determine the incidence, risk factors, and outcomes of unplanned extubation among adult patients. Methods We conducted a prospective cohort study of adult intubated patients admitted to the charity wards of a government tertiary teaching hospital in the Philippines. Patients managed in both intensive care and nonintensive care settings were included. Patients were followed-up until discharge or until seven days postextubation. Results The outcomes of the 191 included patients were planned extubation (35%), unplanned extubation (19%), death (39%), and discharge against advice (7%). Competing risk regression showed that male sex (Crude OR: 2.25, 95%CI: 1.10 - 4.63) and age (Crude OR 0.976, 95%CI: 0.957 - 0.996) were significant baseline factors. The night shift (Crude OR: 24.6, 95%CI: 2.87 - 211) was also consistently associated with more unplanned extubations. Among postextubation outcomes, reintubation (unplanned extubation: 61.1% versus planned extubation: 25.4%), acute respiratory failure (unplanned extubation: 38.9% versus planned extubation: 17.5%), and cardiovascular events (unplanned extubation: 8.33% versus planned extubation: 1.49%) occurred significantly more often among the unplanned extubation patients. Admission in an intensive care unit was not associated with a lower risk of unplanned extubation (Crude OR 1.15, 95%CI: 0.594 - 2.21). Conclusion Many intubated patients had unplanned extubation. Patients admitted in nonintensive care unit settings did not have significantly higher odds of unplanned extubation.

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Section: Introductionmentioning

confidence: 99%

Incidence, risk factors, and outcomes of unplanned extubation in adult patients in a resource-limited teaching hospital in the Philippines: a cohort study

Uy¹,

Ramos²,

Rivera³

et al. 2019

Revista Brasileira De Terapia Intensiva

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“…Patients in ICU suffer from a variety of uncomfortable and painful conditions such as that come with endotracheal intubation and kinds of treatment may led to agitation and delirium. Agitation and delirium increase the risk of UEE directly (Kwon & Choi, 2017), meanwhile the increased needs due to discomfort, and desire to communicate also increase the risk of UEE (Danielis et al., 2018). The six kind of commonly used pain scales (Behavior Pain Scale [BPS]; Pain Assessment Behavioral Scale with Numeric Rating Scale [NRP]); etc.)…”

Section: Discussionmentioning

confidence: 99%

“…

Endotracheal intubation is an essential life-saving intervention, and unplanned endotracheal extubation (UEE) is one of the most frequent incidents reported among the patients with endotracheal intubation. According to incomplete statistical analyses, UEE has high incidence, ranging from 3.4% to 22.5% (Kwon & Choi, 2017;Yeh et al, 2004). UEE may result in serious harm, including dyspnea, airway trauma, laryngeal and tracheal edema, difficult reintubation, hospital-acquired infections and even death (Aydogan & Kaya, 2017;Kiekkas et al, 2013).Reducing the rate of UEE is an important goal in nursing management in the ICU (Chang, Liu, Huang, Yang, & Chang, 2011).

…”

mentioning

confidence: 99%

Design of assessment tool for unplanned endotracheal extubation of artificial airway patients

Zhang

Liu

2021

Nursing Open

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Aim Unplanned endotracheal extubation (UEE) is one of the most common adverse events reported in patients with artificial airway. Current research in UEE is mostly limited to the summary of risk factors and analysis of prevention strategies. The aim of the study was to develop an assessment tool for medical staff to assess the risk of unplanned extubation in endotracheal intubation patients. Design The design was a qualitative study. Methods Based on literature review, group discussion, pre‐investigation, the initial risk assessment scale on unplanned extubation for endotracheal intubation patients was established. Fifteen experts from thirteen tertiary‐A hospitals across eight provinces participated in two rounds of Delphi panel. Results The risk assessment tool on unplanned extubation for endotracheal intubation patients was established by the Delphi method. It was composed of 11 indicators, which got agreement among two rounds panel.

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“…Os artigos incluídos na pesquisa apontaram para eventos adversos como: extubação não planejada e a ocorrência de LPP em UTI. Na equipe multiprofissional destaca-se a enfermagem como categoria com posição de destaque para atuar na prevenção desses eventos adversos, pois além de detectá-los precocemente, ela pode contribuir para a redução das complicações (Kwon & Choi, 2017).…”

Section: Discussionunclassified

Redução do tempo de internação em Unidade de Terapia Intensiva associado à assistência de enfermagem: Revisão integrativa da literatura

Santos

Silva

Dias

et al. 2021

RSD

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Objetivo: Analisar as evidências científicas acerca da associação entre a assistência de enfermagem e a redução do tempo de internação em unidades de terapia intensiva. Método: Trata-se de um estudo bibliográfico do tipo revisão integrativa de literatura, realizado nas bases de dados MEDLINE, BDENF e LILACS, no período de janeiro de 2015 a janeiro de 2020, e submetidos à metodologia do fluxograma prisma. Com a busca identificaram-se 11 artigos sobre a associação entre a assistência de enfermagem e a redução do tempo de internação em unidades de terapia intensiva adulto. Resultados: Identificou-se a prevenção de eventos adversos, mobilização, realização da sistematização da assistência de enfermagem, manejo do delirium e monitorização, como aspectos capazes de melhorar qualidade de vida do paciente e reduzir o tempo de permanência na unidade de terapia intensiva. Conclusão: A enfermagem tem um importante papel na realização dos cuidados críticos, a sua atuação visando a prevenção de eventos adversos contribui para a redução do tempo de internação em unidades de terapia intensiva.

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Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation

Abstract: ICU nurses should be able to recognize the risk factors of unplanned extubation related with the components of the safety model so as to improve patient safety by minimizing the risk for unplanned extubation.

Cited by 19 publications

References 21 publications

Incidence, risk factors, and outcomes of unplanned extubation in adult patients in a resource-limited teaching hospital in the Philippines: a cohort study

Incidence, risk factors, and outcomes of unplanned extubation in adult patients in a resource-limited teaching hospital in the Philippines: a cohort study

Design of assessment tool for unplanned endotracheal extubation of artificial airway patients

Redução do tempo de internação em Unidade de Terapia Intensiva associado à assistência de enfermagem: Revisão integrativa da literatura

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