中部某醫學中心加護病房非計畫性拔管的相關因素探討

Unplanned Extubation in an Intensive Care Unit in Central Taiwan

賴美玉(Mei-Yu Lai) ； 王淑盈(Shu-Ying Wang) ； 葉必明(Pi-Ming Yeh) ； 曾淑梅(Shu-Mei Taeng)

《中山醫學雜誌》 19卷2期 (2008/12) Pp. 147-157

https://doi.org/10.30096/CSMJ.200812.0002

摘要

Purpose: The purpose of this study was to explore the factors influencing unintentional extubation in one medical center.
Materials and Methods: In this retrospective study, we reviewed patient charts and collected data regarding the occurrence unintentional extubation in a cardiac intensive care unit, a medical intensive care unit, and surgical intensive care unit in one hospital in Central Taiwan from January 1, 2003 to June 30, 2005. Independent-samples t-test, paired-samples t-test, and Chi-Square were used to examine the differences between group variables. Statistical operations were performed SPSS PC Version 10.0.
Results: We recruited a total 274 patients in whom unintentional extubations had occurred. Begin Most patients (72.3%) were 60 years old or older, male (70.8%), diagnosed with chest problems (34.3%), clear in consciousness (67.5%), not using sedatives, pain relievers, or muscle relaxants before unintentional extubation (74.5%), had both hands restrained (77.7%), and were slightly able to raise up and flex both hands once they were put on restraints (66.2%). For many (n=126, 46.2%), we were used A/C model on the respiratory assistive machine and many (n=167, 60.9%) were not re-intubated after the unintentional extubation Few had complications resulting from the reintubation (n=10, 3.6%). With regard to ward staffing, most nurses were N zero level nurses (38.8%), had one year nursing experience (n=87, 31.8%), were working the night shift (n=100, 36.5%), and were administering unrelated types of care when the extubation occurred (67.2%).
Conclusion: This study found several causes of unintentional extubation. The injury and complication related to unintentional extubation not only increase medical costs and the duration of the hospitalization, but also increase the disease severity. Therefore, it is important to increase professional knowledge of care, emphasizing the possibility of several consequences of unintentional extubation. Emphasis should also be placed on patients' conscious level and continuous care. This can be done through continuing nursing education and patient education, and development of standard prevention measures to reduce unintentional extubation.

關鍵字

非計畫性拔管

並列摘要

Purpose: The purpose of this study was to explore the factors influencing unintentional extubation in one medical center.
Materials and Methods: In this retrospective study, we reviewed patient charts and collected data regarding the occurrence unintentional extubation in a cardiac intensive care unit, a medical intensive care unit, and surgical intensive care unit in one hospital in Central Taiwan from January 1, 2003 to June 30, 2005. Independent-samples t-test, paired-samples t-test, and Chi-Square were used to examine the differences between group variables. Statistical operations were performed SPSS PC Version 10.0.
Results: We recruited a total 274 patients in whom unintentional extubations had occurred. Begin Most patients (72.3%) were 60 years old or older, male (70.8%), diagnosed with chest problems (34.3%), clear in consciousness (67.5%), not using sedatives, pain relievers, or muscle relaxants before unintentional extubation (74.5%), had both hands restrained (77.7%), and were slightly able to raise up and flex both hands once they were put on restraints (66.2%). For many (n=126, 46.2%), we were used A/C model on the respiratory assistive machine and many (n=167, 60.9%) were not re-intubated after the unintentional extubation Few had complications resulting from the reintubation (n=10, 3.6%). With regard to ward staffing, most nurses were N zero level nurses (38.8%), had one year nursing experience (n=87, 31.8%), were working the night shift (n=100, 36.5%), and were administering unrelated types of care when the extubation occurred (67.2%).
Conclusion: This study found several causes of unintentional extubation. The injury and complication related to unintentional extubation not only increase medical costs and the duration of the hospitalization, but also increase the disease severity. Therefore, it is important to increase professional knowledge of care, emphasizing the possibility of several consequences of unintentional extubation. Emphasis should also be placed on patients' conscious level and continuous care. This can be done through continuing nursing education and patient education, and development of standard prevention measures to reduce unintentional extubation.

並列關鍵字

unintentional extubation