Title

降低新生兒加護病房非計畫性氣管內管滑脫率

Translated Titles

Reducing the Unplanned Removal Rate of Endotracheal Tubes in the Neonatal Intensive Care Unit

DOI

10.29494/LN.202103_22(1).0010

Authors

黃麗卿(Li-Chin Huang);林侑慧(Yu-Hui Lin);李秉儀(Ping-I Lee)

Key Words

新生兒加護病房 ; 非計畫性氣管內管滑脫 ; neonatal intensive care unit ; unplanned extubation

PublicationName

領導護理

Volume or Term/Year and Month of Publication

22卷1期(2021 / 03 / 01)

Page #

131 - 146

Content Language

繁體中文

Chinese Abstract

氣管內管對病人氣道的維護是很重要的,且非計劃性氣管內管滑脫率是醫療品質重要指標,一旦發生非計畫性滑脫,不僅對醫院成本造成耗費,也會危害病人安全。單位為新生兒加護病房,2016年氣管內管滑脫率高達1.15%,分析原因為無合宜之約束輔具、固定膠布滲濕未及時更換及未落實氣管內管照護安全。於2017年4月至2018年2月使用新生兒保護性約束輔具、改變氣管內管固定方式、訂定氣管內管照護評核表、製作教學影片及舉辦教育訓練等方案實施,非計畫性氣管內管滑脫率降至0%,達目標值。且護理人員於氣管內管照護安全執行率由46.4%提升至87.8%,有效提升了新生兒加護病房氣管內管照護品質,達年度病人安全工作目標。

English Abstract

The endotracheal tube is very important to the maintenance of the patient's airways, and the unplanned extubation (UE) rate is an important indicator to the medical quality. Once the unplanned removal occurs, apart from financial costing to the hospital, it will also endanger patient's safety. In 2016, the rate of UE in our neonatal intensive care unit was as high as 1.15%. After assessing the issue, we concluded problems include lack of suitable restraint aids, fixed adhesive tapes were not replaced in a timely manner, and lack of endotracheal tube care in-service education and securing techniques. After establish the methods aiming to reduce the risk of UE rate, those include apply the neonatal protective restraint aids, changes in the endotracheal tube adhesive tape fixation, design a protocol and checklist for securing endotracheal tubes care, produce teaching videos, organize educational training and so on. After implementing those measures, the rate of unplanned removal drop dramatically from 1.15% to 0%. In addition, the safety execution rate of nursing staff in endotracheal tube care increased from 46.4% to 87.8%. Our strategy has effectively improved the quality of endotracheal care in the neonatal intensive care unit, reduced the rate of UE, and reached the annual safety working goal for patients.

Topic Category 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學