Developing Nursing Guidelines to Prevent Unplanned Endotracheal Tube Removal in Patients Admitted to Medical Intensive Care Unit
Keywords:
unplanned endotracheal tube removal, nursing guideline, endotracheal tube removalAbstract
This research and development aimed to study the situation and cause of unplanned extubation tube, to develop nursing guidelines, and to study the effectiveness of nursing guidelines for preventing unplanned extubation tube in patients admitted to the medical intensive care unit, Naradhiwas Rajanagarindra Hospital. This research study was conducted during June-July 2021, consisted of 3 phases: Phase 1, to study the situation and causes of extubation; Phase 2, to develop nursing guidelines; and Phase 3, to evaluate of effectiveness of nursing guidelines to prevent unplanned extubation. There were 30 critically ill patients undergoing oral intubation. The study instruments were unplanned extubation tube risk assessment and nursing guidelines developed from phase 2. A situational study from a 1-year retrospective review of medical records found that the incidence of unplanned extubation tube was 9.54 times per 1,000 intubation days. The cause of the unplanned extubation tube were the level of consciousness changes and the tying of the wrist and endotracheal tube was not standardized. The researcher developed a nursing guideline and the effectiveness of implementing care guideline to prevent unplanned extubation tube. It consisted of 4 items of risk assessment of unplanned extubation tube and 11 items of nursing care. After using the nursing approach to prevent unplanned extubation tube, the incidence was reduced to 4.1 per 1,000 intubation days. Therefore, it is suggested to follow the approach, this helps reduce the incidence of unplanned extubation tube and develop quality of patient care.
References
Berkow, L., & Kanowitz, A. (2020). Unplanned extubation: A common and costly complication of airway management. Patient Safety, 3(1), 22-30.
Chaiweeradej, M., Euakit, N., & Uamtani, A. (2013). An adult who has been on a ventilator. Songklanakarin Journal of Nursing, 33(2), 31-46.
Chuthip, P. (2020). The Effect of Nursing Protocol for Prevention of Unplanned Extubation in
Medical Patients, Phattalung Hospital. Journal of Health Research and Innovation, 3(1), 31- 45.
Cui, N., Zhang, Y., Liu, Y., Zhou, Y., Sun, H., & Jin, J. (2021). Protocol for the adaptation of clinical practice guidelines for the management of physical restraints in critically ill patients. Annals of Palliative Medicine, 10(4), 4889-4896.
Dang, D., & Dearholt, S. L. (2019). Johns Hopkins nursing evidence-based practice: Model
and guidelines (Edition 2).
Dejdee, S. & Nukaew, O. (2021). Development and Effects of Empowerment Programs. on self-care behaviors in patients with substance abuse-related psychosis. Journal of Psychiatric Nursing and Mental Health, 35(1), 92-111.
Deming, W.E. (1986). Quality, Productivity and Competitive Position. Cambridge : Center for Advance Engineering, Massachusetts Institute of Technology.
Kato, M., Fauziah, W., Yamashita, T., Nishijima, S., Kima, M., Iida, M., & Pham, H. T. T. (2021). Prevalence and prevention of unplanned removal of tubes and catheters among hospitalized patients. International Journal of Caring Sciences, 14(1), 385.
Krasao, P. (2020). The Effect of Clinical Nursing Practice on the Prevention of Unplanned Endotracheal Extubation in General Medical Wards, Phrae Hospital. Journal of the Phrae Hospital, 28(1). 27-41.
Kimnarak, S., Sukhong, R., Pimdee, Y., & Jaikla, S. (2019). The effectiveness of the use of the nursing practice to prevent unplanned removal of the endotracheal tube intensive care unit Nakhon Pathom Hospital. Journal of Medicine, 38(3), 210-225.
Lapthawee, B. & Thammaraksa, T. (2015). The incidence of unplanned endotracheal tube removal of Patients admitted to hospitals in accident and emergency surgery wards 1, Thammasat Hospital honor. Thammasat University Hospital. (in Thai)
Lin, Y. P., & Wu, M. (2019). The PEST Model: A Quality Improvement Project to Reduce Self-extubation in the Intensive Care Unit. Dimensions of Critical Care Nursing, 38(4), 221-227.
Nakrit, B., Namwongprom, A., & Phakdiwong, N. (2015). Slippage of the tracheal tube. and the time of inserting the machine Rescue breathing in critically ill patients who are cared for using a guideline Evidence-Based Nursing. Kuakarun Journal, 22(1), 129-143.
Na nakorn, N., (2020). Effectiveness of Implementing Clinical Nursing Practice Guidelinesfor Prevention of Unplanned Endotracheal Extubations in Medical Intensive Care Unit, Suratthani Hospital.
Norakhun, S., Namchantra, R. & Binhosen, W. (2016). The effect of the nursing practice guideline on The incidence of endotracheal tube removal Unplanned in intubation patients. Journal of Nursing Cardiovascular Disease , 27(1), 72-83.
Pokathip, S., Salakkhum, P., Suttiprapa, T., Datawee, P., Kwanchang, P., & Sanaphrom, N. Prevalence. (2019). Risk Factor and Nursing Care of Unplanned Extubation. Health Science Journal Boromarajonani College of Nursing, 3(3), 53-67.
Rungruang, W. (2020). Toxicology of Kratom. Journal of Hospital Pharmacy , 30(2), 118-124.
Saengsri, S. (2012). Development and evaluation of nursing practice guidelines for prevention of endotracheal tube removal. Unplanned breathing in the intensive care unit Songkhla Nakarin Hospital[Thesis Master of Nursing degree]. Songkhla: Prince of University. (in Thai)
Salakkham, P., Phokthip, S., Charoensri, P., Wasombat, O., Phumthong, P., Suttason, M., … , K., & Naiyaphat, W.. (2017). Effects of the Nursing Practice Guideline. on the incidence of endotracheal tube dislocation in severely intubated patients. Journal of Nursing and Education , 10(2), 58-70.
Suliman, M. (2018). Prevalence of physical restraint among ventilated intensive care unit patients. Journal of Clinical Nursing, 27, 3490-3496.
Tanios, M., Epstein, S., Grzeskowiak, M., Nguyen, HM., Park, H., & Leo, J. (2014). Influence of sedation strategies on unplanned extubation in a mixed intensive care unit. Journal of Critical Care, 23(4), 306–315.
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Princess of Naradhiwas University Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
