Department of Nursing, Cathay General Hospital, Sijhih, Taipei, Taiwan.
Appl Nurs Res. 2011 Aug;24(3):188-92. doi: 10.1016/j.apnr.2009.09.002. Epub 2009 Oct 21.
This 3-year retrospective case-control study aimed to identify risk factors associated with unplanned endotracheal self-extubation (UESE) of hospitalized intubated patients and to compare unplanned and planned extubation groups' characteristics of patients and nurses, vital signs, serum laboratory values, Glasgow Coma Scale scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and use of physical restraints and sedatives. The study found that most UESEs occurred during evening or night shifts or during shifts staffed by nurses with less experience and less education. Most of the self-extubated patients (80%) were physically restrained. Pulse rate and APACHE II score were both significant predictors of UESE. Efforts to prevent UESEs should include identification of patients at higher risk.
本为期 3 年的回顾性病例对照研究旨在确定与住院插管患者计划外经口气管插管自行拔出(UESE)相关的风险因素,并比较计划外和计划拔管组患者和护士的特征、生命体征、血清实验室值、格拉斯哥昏迷评分、急性生理学和慢性健康评估 II(APACHE II)评分以及身体约束和镇静剂的使用情况。研究发现,大多数 UESE 发生在傍晚或夜间班次,或者由经验和教育程度较低的护士值班期间。大多数自行拔管的患者(80%)都受到身体约束。脉搏率和 APACHE II 评分均是 UESE 的显著预测因子。预防 UESE 的措施应包括识别风险较高的患者。