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Unplanned extubation

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https://www.readbyqxmd.com/read/28912056/revisiting-unplanned-extubation-in-the-pediatric-intensive-care-unit-what-s-new
#1
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...
September 11, 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
#2
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...
August 25, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28866624/severe-acquired-subglottic-stenosis-in-neonatal-intensive-care-graduates-a-case-control-study
#3
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
#4
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...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28819204/prognostic-factors-and-outcomes-of-unplanned-extubation
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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.
May 11, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28400683/factors-associated-with-reintubation-in-an-intensive-care-unit-a-prospective-observational-study
#14
Eric Shih Hsiung Lee, Danny Tse Jiann Lim, Juvel Mabao Taculod, Juliet Tolentino Sahagun, Joerie Pasive Otero, Kaimin Teo, Will Ne-Hooi Loh, Addy Yong Hui Tan
BACKGROUND AND AIMS: The objective of the study was to determine the incidence of failed extubations in our Intensive Care Unit (ICU) and identify associated clinical factors. MATERIALS AND METHODS: A prospective observational study of mechanically ventilated patients who underwent extubation attempts in our (predominantly surgical) ICU was undertaken from July 2012 to August 2013. The primary endpoint was the need for nonelective reintubation within 72 h of extubation...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28400408/incidence-and-risk-factors-for-cardiovascular-collapse-after-unplanned-extubations-in-the-pediatric-icu
#15
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for ≥12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE...
April 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28388984/case-control-study-on-risk-factors-of-unplanned-extubation-based-on%C3%A2-patient-safety-model-in-critically-ill-patients-with-mechanical-ventilation
#16
EunOk Kwon, KyungSook Choi
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...
March 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/28341980/implementation-and-evaluation-of-a-paediatric-nurse-driven-sedation-protocol-in-a-paediatric-intensive-care-unit
#17
Lélia Dreyfus, Etienne Javouhey, Angélique Denis, Sandrine Touzet, Fabienne Bordet
BACKGROUND: Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data suggest that goal-directed sedation algorithms reduce the duration of mechanical ventilation. We implemented a nurse-driven sedation protocol in a PICU and evaluated its impact...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28297813/-clinical-application-and-evaluation-of-an-early-non-sedation-protocol-for-critically-ill-respiratory-patients
#18
RANDOMIZED CONTROLLED TRIAL
J B Huang, C Q Lan, H Y Li, L Chen, J G Pan, L L Chen, H Weng, Y M Zeng
Objective: To study the value of an early (mechanical ventilation after 24 h) non-sedation protocol for intubated, mechanically ventilated patients in the respiratory intensive care unit (RICU). Methods: Seventy intubated, mechanically ventilated patients were prospectively enrolled and randomly assigned to management with early non-sedation (intervention group; n=35) or with daily interruption of sedation (DIS) (control group; n=35). The duration of mechanical ventilation, length of the RICU and hospital stay, RICU and hospital mortality, drug consumption, RICU and hospitalization expenses, incidence of complications and adverse events and serum levels of vital organ damage and inflammatory markers after mechanical ventilation for 48 h were recorded and compared...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28151492/counting-unplanned-extubations-marked-variation-among-neonatologists
#19
S Mbi Ndakor, M U Nelson, J M B Pinheiro
OBJECTIVE: To assess if neonatologists detect and count unplanned extubations (UEs) uniformly. STUDY DESIGN: An Institutional Review Board-exempted anonymous web-based survey of neonatology attending and fellow members of the AAP Neonatal-Perinatal Medicine section was administered. Respondents were queried on practices concerning UE; they were then presented with different case scenarios and asked if they would count the event as a UE. RESULTS: Of the 509 respondents, 61% track UE rates...
June 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#20
Semine Aydoğan, Nurten Kaya
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...
January 2017: Dimensions of Critical Care Nursing: DCCN
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