Semine Aydoğan1, Nurten Kaya. 1. Semine Aydoğan, MSc, BSN, is a nurse in the intensive care unit, Anesthesiology and Resuscitation Department, Cerrahpaşa Medical Faculty, Istanbul University, Turkey. Dr Aydoğan graduated from Istanbul University, Bakirkoy Health School Nursing Department in 2010. She has a master's degree at Istanbul University in 2015. She is a nurse in the intensive care unit, Anesthesiology and Resuscitation Department, Cerrahpaza Medical Faculty, Istanbul University, Turkey. Nurten Kaya, PhD, BSN, is an associate professor, Health Sciences Faculty, Istanbul University, Turkey. Dr Kaya graduated from Istanbul University, Florence Nightingale School of Nursing in 1987. She completed her PhD from Istanbul University, Institute of Health Sciences in 2002. She worked at Florence Nightingale Faculty of Nursing, Department of Fundamentals of Nursing between from 1993 to 2013 and she has worked at the Health Sciences Faculty since 2013. Her areas of interest are intramuscular injection, complementary therapy, nursing informatics, nursing theories and models, nursing process and nursing care. She has articles, book chapters and other publications on fundamentals of nursing and she is leader of statutory research projects. She is member of Turkish Nurses Society, Nursing Education Society, and Graduates Florence Nightingale School of Nursing Society.
Abstract
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital. The sample from this population was composed of patients whose extubation was unplanned (30 patients) and the randomly selected patients (60 patients) who were intubated at the same time in the ICU for each patient whose extubation was unplanned. In data collection, the Richmond Agitation-Sedation Scale, Glasgow Coma Scale, Acute Physiology and Chronic Health Evaluation II were utilized. FINDINGS: According to the findings, the variables such as sex, age, mechanical ventilation period, and Acute Physiology and Chronic Health Evaluation II and Glasgow Coma Scale scores did not have any effect on the unplanned extubation, but variables such as internal medicine diseases and Richmond Agitation-Sedation Scale did have an effect. It was also revealed that there was no extubation plan in most of the unplanned extubation group, the nurse was anticipating the unplanned extubation, the patient was intubated again, and a complication occurred. CONCLUSION: The patients who are provided inadequate sedation and analgesia and who have problems in their respiratory system are under risk of unplanned extubation. RELEVANCE TO CLINICAL PRACTICE: In order to prevent unplanned extubation, an adequate amount of sedation and private nursing care should be provided to patients in the ICU.
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital. The sample from this population was composed of patients whose extubation was unplanned (30 patients) and the randomly selected patients (60 patients) who were intubated at the same time in the ICU for each patient whose extubation was unplanned. In data collection, the Richmond Agitation-Sedation Scale, Glasgow Coma Scale, Acute Physiology and Chronic Health Evaluation II were utilized. FINDINGS: According to the findings, the variables such as sex, age, mechanical ventilation period, and Acute Physiology and Chronic Health Evaluation II and Glasgow Coma Scale scores did not have any effect on the unplanned extubation, but variables such as internal medicine diseases and Richmond Agitation-Sedation Scale did have an effect. It was also revealed that there was no extubation plan in most of the unplanned extubation group, the nurse was anticipating the unplanned extubation, the patient was intubated again, and a complication occurred. CONCLUSION: The patients who are provided inadequate sedation and analgesia and who have problems in their respiratory system are under risk of unplanned extubation. RELEVANCE TO CLINICAL PRACTICE: In order to prevent unplanned extubation, an adequate amount of sedation and private nursing care should be provided to patients in the ICU.