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Unplanned extubation

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https://www.readbyqxmd.com/read/29135753/prevention-of-neonatal-unplanned-extubations-in-the-neonatal-intensive-care-unit-a-best-practice-implementation-project
#1
Xiaojing Hu, Yuxia Zhang, Yun Cao, Guoying Huang, Yan Hu, Alexa McArthur
BACKGROUND: Adverse events of mechanically ventilated neonates such as unplanned extubations may be associated with serious negative outcomes. Unplanned extubation rates have been monitored by many neonatal intensive care units as a quality of care metric. OBJECTIVES: The objective was to implement evidence-based best practice and assess the effects of these strategies on minimizing unplanned extubation in the neonatal intensive care unit in a large tertiary children's hospital...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29109066/unplanned-intraoperative-extubations-in-pediatric-neurosurgery-analysis-of-case-series-to-increase-patient-safety
#2
Kathryn M Wagner, Jeffrey S Raskin, Nicholas P Carling, Mary A Felberg, Megha K Kanjia, I-Wen Pan, Thomas G Luerssen, Sandi Lam
No abstract text is available yet for this article.
November 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29027656/pulmonary-complications-after-non-cardiac-surgeries-temporal-patterns-and-risk-factors
#3
Cássia Toledo, Flávio Eduardo Nácul, Marcos Freitas Knibel, Nilton Brandão Silva, Ederlon Rezende, Cintia Magalhães Carvalho Grion, Murillo Assunção, Fernando Gutierrez, Joelma Villafanha Gandolfi, Suzana Margareth Lobo
BACKGROUND: Postoperative complications are the primary determinants of survival following major surgery. We aimed to characterize the early perioperative risk factors for postoperative pulmonary complications (POPCs) in patients undergoing major non-cardiac surgeries. METHODS: This study utilized a multicenter prospective observational cohort design. Adult patients undergoing non-cardiac surgeries and admitted to 21 Brazilian ICUs were screened for inclusion in the study...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29026823/ivy-loop-wiring-a-useful-form-of-endotracheal-tube-stabilization-in-burn-patients
#4
Matthew W T Curran, Edward E Tredget
The stabilization of endotracheal tubes in the burn population presents many problems. Access to the face for dressings, debridements, and the use of topical antimicrobials prevent adequate stabilization of the endotracheal tube with commonly used methods. Conventional methods have an increased risk of shifting, which can lead to injury to the friable burned tissue or unplanned extubation. To prevent these complications, alternative methods using the dentition to stabilize the endotracheal tube have been described...
August 2017: Plastic Surgery
https://www.readbyqxmd.com/read/28987753/prospective-evaluation-of-physical-contact-with-critically-ill-child-on-caregiver-spiritual-wellbeing
#5
Brian D Leland, Mara E Nitu, Maureen Hancock, Karen Moody, Richard Gunderman, Elizabeth Moser, Courtney M Rowan
OBJECTIVES: To evaluate whether a pediatric intensive care unit initiative promoting physical contact between caregiver and patient improves caregiver spiritual wellbeing. The secondary objectives were to evaluate caregiver perceptions of care before and after the initiative and to follow unplanned extubation rate as a marker of safety of the initiative. We hypothesized that caregiver spiritual wellbeing and caregiver perceptions of care would improve with implementation of our physical contact initiative known as Project ROSE (Reach Out, Soothe, and Embrace)...
October 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28948590/-the-effect-of-family-member-reminders-on-reducing-anxiety-and-unplanned-extubation-in-icu-patients
#6
Li-Ching Lin, Yann-Fen C Chao, Pi-Chu Lin
BACKGROUND: Patients with endotracheal intubation often experience anxiety because they are unable to express their needs freely. However, the family members of these patients are able to provide encouragement, comfort, and substantive support. PURPOSE: The aims of the present study were: (1) to compare the anxiety scores, vital signs, and incidence of unplanned extubation (UE) between the two comparison groups; (2) to compare the differences in vital signs before and after the intervention in the experimental group; and (3) to explore the satisfaction of patients in the experimental group with the intervention...
October 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28934894/factors-associated-with-unplanned-extubation-in-children-a-case-control-study
#7
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
PURPOSE: Although several studies assess unplanned extubation (UE) in children, few have addressed determinants of UE and factors associated with reintubation in a case-controlled manner. We aimed to identify the risk factors and outcomes associated with UE in a pediatric intensive care unit. METHODS: Cases of UE were randomly matched with control patients at a ratio of 1:4 for age, severity of illness, and admission diagnosis. For cases and controls, we also collected data associated with UE events, reintubation, and outcomes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28912056/revisiting-unplanned-extubation-in-the-pediatric-intensive-care-unit-what-s-new
#8
REVIEW
Paulo Sérgio Lucas da Silva, Daniela Farah, Marcelo Cunio Machado Fonseca
In 2010, recommendations for preventing unplanned extubations (UEs) in pediatric patients were published based on a literature review. Since then, there have been an increasing number of publications related to UE focusing on children. If the introduction of care bundles and larger body of evidence on UE had impact on UE occurrence, this would have important implications on clinical practice. We searched for relevant publications published between Jan 1, 2010 and Jun 30, 2016 in the MEDLINE, EMBASE, and Cochrane systems...
November 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28892726/a-safety-culture-training-program-enhanced-the-perceptions-of-patient-safety-culture-of-nurse-managers
#9
Jian-Fei Xie, Si-Qing Ding, Zhu-Qing Zhong, Sai-Nan Zeng, Chun-Xiang Qin, Qi-Feng Yi, Li-Na Gong, Jian-da Zhou
Positive perceptions of patient safety culture are associated with lower rates of adverse events, but they have not been widely established in many health care organizations. The purpose of this study is to examine the impacts of a safety culture training program (SCTP) on enhancing the perceptions of patient safety in nurse managers. This was a quasi-experimental design. 83 nurse managers were recruited from five randomly selected 2nd level hospitals. Sixty-seven nurse managers received training under the educational SCTP...
November 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28866624/severe-acquired-subglottic-stenosis-in-neonatal-intensive-care-graduates-a-case-control-study
#10
Rebecca E Thomas, Shripada C Rao, Corrado Minutillo, Shyan Vijayasekaran, Elizabeth A Nathan
OBJECTIVE: To analyse current incidence and risk factors associated with severe acquired subglottic stenosis (SASGS) requiring surgical intervention in neonates. DESIGN: Retrospective case-control study. SETTING: Sole tertiary children's hospital. PARTICIPANTS: Patients who underwent surgical intervention for SASGS from January 2006 to December 2014. For each neonatal intensive care unit (NICU) graduate with acquired SASGS, two controls were selected (matched for gestation and year of birth)...
September 2, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28821360/development-and-implementation-of-an-early-mobility-program-for-mechanically-ventilated-pediatric-patients
#11
Kristina A Betters, Kiran B Hebbar, David Farthing, Brittany Griego, Tricia Easley, Hartley Turman, Lauren Perrino, Stephanie Sparacino, Mary L deAlmeida
PURPOSE: Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. METHODS: A multidisciplinary EM committee was formed to create and implement an EM protocol in a quarternary care PICU...
October 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28819204/prognostic-factors-and-outcomes-of-unplanned-extubation
#12
Chien-Ming Chao, Mei-I Sung, Kuo-Chen Cheng, Chih-Cheng Lai, Khee-Siang Chan, Ai-Chin Cheng, Shu-Chen Hsing, Chin-Ming Chen
This study investigated the prognostic factors and outcomes of unplanned extubation (UE) in patients in a medical center's 6 intensive care units (ICUs) and calculated their mortality risk. We retrospectively reviewed the medical records of all adult patients in Chi Mei Medical Center who underwent UE between 2009 and 2015. During the study period, there were 305 episodes of UE in 295 ICU patients (men: 199 [67.5%]; mean age: 65.7 years; age range: 18-94 years). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#13
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28682859/multidisciplinary-interventions-and-continuous-quality-improvement-to-reduce-unplanned-extubation-in-adult-intensive-care-units-a-15-year-experience
#14
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Chung-Han Ho, Chin-Ming Chen, Willy Chou
We conduct a retrospective study of patients with unplanned extubation (UE) in adult intensive care units (ICU) at a medical center. In 2001, a multidisciplinary team of intensivists, senior residents, nurses, and respiratory therapists was established at Chi Mei Medical Center. The improvement interventions, implemented between 2001 and 2015, were organized around 8 key areas: standardizing procedures, improving communication skills, revising sedation and weaning protocols, changing strategies for restraints, establishing a task force for identifying and managing high-risk patients, using new quality-improvement models as breakthrough series and team resource management, using the strategy of accountability without assigning blame, and changing a new method to secure endotracheal tube...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28618046/open-label-randomized-controlled-trial-about-application-of-bundle-care-in-prevention-of-unplanned-extubation-of-nasobiliary-drainage-catheter-after-endoscopic-retrograde-cholangiopancreatography
#15
Chun-Mei Zhao, Jun-Bo Qian, Chun-Mei Zhang, Gang Lin
OBJECTS: To observe the effects of bundle care on preventing unplanned extubation (UEX) of nasobiliary drainage catheter after endoscopic retrograde cholangiopancreatography (ERCP). BACKGROUND: Preventing UEX has become a difficult problem for nursing staff because the catheter is stiff, fine and long. DESIGN: A total of 114 cases that experienced nasobiliary drainage after ERCP for the first time in our hospital from April 2015 to July 2016, were enrolled in this study...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28559465/reducing-unplanned-extubations-in-the-nicu-following-implementation-of-a-standardized-approach
#16
Kevin L Crezeé, Robert J DiGeronimo, Marilyn J Rigby, Rick C Carter, Shrena Patel
BACKGROUND: Unplanned extubations (UEs) have been associated with increased ventilator days, risk of infection, cardiopulmonary resuscitation, and resuscitation medication usage. The UE rate in our level 4 NICU is lower than the national average. Efforts to further reduce UE events at our institution led an interdisciplinary group to define steps to eliminate UEs. Steps included: (1) requiring at least 2 care providers at the bedside for movement of an intubated subject; (2) standardizing head and endotracheal tube (ETT) position; (3) defining a set methodology for ETT securing; (4) introducing a postoperative handoff to improve communication; and (5) implementing a post-UE assessment tool...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28539199/respiratory-severity-score-and-extubation-readiness-in-very-low-birth-weight-infants
#17
Maroun J Mhanna, Narayan P Iyer, Scott Piraino, Mohit Jain
BACKGROUND: The respiratory severity score (RSS) is a byproduct of mean airway pressure (MAP) and fraction of inspired oxygen (FiO2). We sought to determine whether RSS could be used as a screening tool to predict extubation readiness in very low birth weight (VLBW) infants. METHODS: In a retrospective cohort study, medical records of all VLBW infants admitted to our unit (6/1/09-2/28/12) were reviewed for infants' demographics, prenatal characteristics, and medication use...
May 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28538443/an-airway-management-protocol-after-anterior-cervical-spine-surgery-analysis-the-results-of-risk-factors-associated-with-airway-complication
#18
Moinay Kim, Il Choi, Jin Hoon Park, Sang Ryong Jeon, Seung Chul Rhim, Sung Woo Roh
STUDY DESIGN: Retrospective comparative cohort analysis. OBJECTIVE: To evaluate the effect of postoperative airway management protocol (ASAN Extubation Protocol, AEP) on incidence of airway complications for patients undergoing anterior cervical spine surgery (ACSS). SUMMARY OF BACKGROUND DATA: Postoperative airway compromise remains crucial for patients undergoing ACSS. Despite the potential severity of these complications, the data in the published literature addressing this issue is sparse...
May 19, 2017: Spine
https://www.readbyqxmd.com/read/28538057/an-airway-risk-assessment-score-for-unplanned-extubation-in-intensive-care-pediatric-patients
#19
Atul Vats, Clara Hopkins, Kelly M Hatfield, Jia Yan, Robert Palmer, Pinar Keskinocak
OBJECTIVE: As a result of a workshop to identify common causes of unplanned extubation, Children's Healthcare of Atlanta developed a scoring tool (Risk Assessment Score) to stratify patients into groups of low, moderate, high, and extreme risk. This tool could be used to institute appropriate monitoring or interventions for patients with high risks of unplanned extubation to enhance safety. The objective of this study is to test the hypothesis that the Risk Assessment Score will correlate with the occurrence rate of unplanned extubation in pediatric patients...
July 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28494497/effect-of-anatomical-and-developmental-factors-on-the-risk-of-unplanned-extubation-in-critically-ill-newborns
#20
L Dupree Hatch, Peter H Grubb, Melinda H Markham, Theresa A Scott, William F Walsh, James C Slaughter, Ann R Stark, E Wesley Ely
No abstract text is available yet for this article.
October 2017: American Journal of Perinatology
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