Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation
Purpose: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. Methods: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extub...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-03-01
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| Series: | Asian Nursing Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1976131716301839 |
| _version_ | 1818355074043215872 |
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| author | EunOk Kwon, RN, Ph.D. KyungSook Choi, RN, Ph.D. |
| author_facet | EunOk Kwon, RN, Ph.D. KyungSook Choi, RN, Ph.D. |
| author_sort | EunOk Kwon, RN, Ph.D. |
| collection | DOAJ |
| description | Purpose: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model.
Methods: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay. Based on the characteristics of the cohort of 230 patients who had unplanned extubation, 460 case control comparison groups with planned extubation were selected by matching age, gender and diagnosis.
Results: Risk factors of unplanned extubation were categorized as people, technologies, tasks, environmental factors and organizational factors, by five components of the patient safety model. The results showed the risk factors of unplanned extubation as admission route [odds ratio (OR) = 1.8], Glasgow Coma Scale–motor (OR = 1.3), Acute Physiology and Chronic Health Evaluation score (OR = 1.06), agitation (OR = 9.0), delirium (OR = 11.6), mode of mechanical ventilation (OR = 3.0–4.1) and night shifts (OR = 6.0). The significant differences were found between the unplanned and the planned extubation groups on the number of reintubation (4.3% vs. 79.6%, p < .001), ICU outcome at the time of discharge (χ2 = 50.7, p < .001), and length of stay in the ICU (27.0 ± 33.0 vs. 43.8 ± 43.5) after unplanned extubation.
Conclusion: ICU nurses should be able to recognize the risk factors of unplanned extubation related with the components of the safety model so as to improve patient safety by minimizing the risk for unplanned extubation. |
| first_indexed | 2024-12-13T19:35:32Z |
| format | Article |
| id | doaj.art-9897ec89371e4b08af58ce043e6b6128 |
| institution | Directory Open Access Journal |
| issn | 1976-1317 |
| language | English |
| last_indexed | 2024-12-13T19:35:32Z |
| publishDate | 2017-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Nursing Research |
| spelling | doaj.art-9897ec89371e4b08af58ce043e6b61282022-12-21T23:33:50ZengElsevierAsian Nursing Research1976-13172017-03-01111747810.1016/j.anr.2017.03.004Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical VentilationEunOk Kwon, RN, Ph.D.0KyungSook Choi, RN, Ph.D.1Director of National Health Insurance Review Team, Seoul National University Hospital, South KoreaProfessor Emeritus, Department of nursing, Chung-Ang University, South KoreaPurpose: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. Methods: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay. Based on the characteristics of the cohort of 230 patients who had unplanned extubation, 460 case control comparison groups with planned extubation were selected by matching age, gender and diagnosis. Results: Risk factors of unplanned extubation were categorized as people, technologies, tasks, environmental factors and organizational factors, by five components of the patient safety model. The results showed the risk factors of unplanned extubation as admission route [odds ratio (OR) = 1.8], Glasgow Coma Scale–motor (OR = 1.3), Acute Physiology and Chronic Health Evaluation score (OR = 1.06), agitation (OR = 9.0), delirium (OR = 11.6), mode of mechanical ventilation (OR = 3.0–4.1) and night shifts (OR = 6.0). The significant differences were found between the unplanned and the planned extubation groups on the number of reintubation (4.3% vs. 79.6%, p < .001), ICU outcome at the time of discharge (χ2 = 50.7, p < .001), and length of stay in the ICU (27.0 ± 33.0 vs. 43.8 ± 43.5) after unplanned extubation. Conclusion: ICU nurses should be able to recognize the risk factors of unplanned extubation related with the components of the safety model so as to improve patient safety by minimizing the risk for unplanned extubation.http://www.sciencedirect.com/science/article/pii/S1976131716301839endotracheal extubationintensive care unitspatient safetyrisk factors |
| spellingShingle | EunOk Kwon, RN, Ph.D. KyungSook Choi, RN, Ph.D. Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation Asian Nursing Research endotracheal extubation intensive care units patient safety risk factors |
| title | Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation |
| title_full | Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation |
| title_fullStr | Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation |
| title_full_unstemmed | Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation |
| title_short | Case-control Study on Risk Factors of Unplanned Extubation Based on Patient Safety Model in Critically Ill Patients with Mechanical Ventilation |
| title_sort | case control study on risk factors of unplanned extubation based on patient safety model in critically ill patients with mechanical ventilation |
| topic | endotracheal extubation intensive care units patient safety risk factors |
| url | http://www.sciencedirect.com/science/article/pii/S1976131716301839 |
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