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

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.