Implications of nursing care in the occurrence and consequences of unplanned extubation in adult intensive care units

Received 22 August 2002; received in revised form 19 July 2003; accepted 25 July 2003.

Abstract

This 18-month study used a structured questionnaire to explore the roles of nursing care on the occurrence and consequences of unplanned endotracheal extubation (UEE) in intensive care units in Taiwan. Experiencing UEE were 225/1176 (22.5%) intubated patients: 91.7% were self-extubations and 8.3% were accidental. Self-extubations occurred most frequently during night shifts and in the care of nurses with less working experience. Accidental extubations occurred most frequently in patients undergoing routine nursing procedures, usually required immediate re-intubation and were associated with more complications. An appropriate nurse-to-patient ratio, better working procedures and continual nursing education programs might help reduce occurrence and complications of UEE.

Keywords: Unplanned extubation, Endotracheal intubation, Intensive care

a Chang Gung Institute of Technology, Chang Gung Hospital at Kaohsiung, 12F, #123, Ta-Pei Rd., Niao-Sung, Kaohsiung Hsiang 833, Taiwan

b Kaohsiung Municipal Tatung Hospital, #68, Chung Hwa 3rd Rd., Kaohsiung 801, Taiwan

c Junior College of Nursing, Chung Hwa Institute of Technology, 3F-15, #21, Lane 235, Te-tung Street, East Distring, Tainan 701, Taiwan

d Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, #123, Ta-Pei Rd., Niao-Sung, Kaohsiung Hsiang 833, Taiwan

e Junior College of Nursing, Fooyin University, #151, Chinhsueh Road, Ta-Liao, Kaohsiung, Hsien 831, Taiwan

Corresponding author

PII: S0020-7489(03)00136-6

doi:10.1016/S0020-7489(03)00136-6

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