2.50
Hdl Handle:
http://hdl.handle.net/10755/155998
Type:
Presentation
Title:
Assessment of a Model for Patients at High Risk for Unplanned Extubations
Abstract:
Assessment of a Model for Patients at High Risk for Unplanned Extubations
Conference Sponsor:Sigma Theta Tau International
Conference Year:2008
Author:Tankel, Nancy, RN, MN
P.I. Institution Name:Kaiser Permanente
Title:Senior Consultant/Adult Services Administrator
Co-Authors:Anna Omery, RN, DNSc
[Research Paper or Poster Presentation] Though mechanical ventilation is a valuable and often essential tool in the critical care environment, several complications may arise as a result of treatment. One such complication includes unplanned extubations (UEx). UEx is an urgent and emergent event that often contributes to morbidity and mortality, as well as less critical consequences such as pneumonia and increased length of mechanical ventilation. The purpose of this prospective, case controlled, comparative study was to develop and test a model that would identify those patients at high risk for unplanned extubation. Of the 86 study patients, data for 77 patients were included in the final analysis. Independent variables included age, gender, diagnosis type, time of day the UEx occurred, total ventilated days, previous UEx, level of consciousness, use of restraints, ventilator mode, pH, ventilator changes within the past 24 hours, and APACHE score. Bivariate association with the outcome variable was completed for each independent variable. Of these, only the variables described as ôlevel of consciousnessö and ôprevious UExö were found to be related statistically to UEx. Logistic regression analysis was completed and no statistical relationship among any of the independent variables was demonstrated. Further analysis of the outcome variable demonstrated that of those who had unplanned extubations, 62% were not reintubated. One can therefore conclude from the lack of significant predictors for UEX in this population, as well as the low frequency of reintubation, that accurate assessment would have been fundamental in the prevention of UEx in this sample. Data collected from this study suggests that clinicians focus their intervention on the assessment of intubated patients and the start of a weaning protocol in order to initiate a planned extubation. Further studies including a larger sample size are warranted in attempts to identify clear predisposing factors of unplanned extubations.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAssessment of a Model for Patients at High Risk for Unplanned Extubationsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155998-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Assessment of a Model for Patients at High Risk for Unplanned Extubations</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Tankel, Nancy, RN, MN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Kaiser Permanente</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Senior Consultant/Adult Services Administrator</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">nancy.s.tankel@kp.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Anna Omery, RN, DNSc</td></tr><tr><td colspan="2" class="item-abstract">[Research Paper or Poster Presentation] Though mechanical ventilation is a valuable and often essential tool in the critical care environment, several complications may arise as a result of treatment. One such complication includes unplanned extubations (UEx). UEx is an urgent and emergent event that often contributes to morbidity and mortality, as well as less critical consequences such as pneumonia and increased length of mechanical ventilation. The purpose of this prospective, case controlled, comparative study was to develop and test a model that would identify those patients at high risk for unplanned extubation. Of the 86 study patients, data for 77 patients were included in the final analysis. Independent variables included age, gender, diagnosis type, time of day the UEx occurred, total ventilated days, previous UEx, level of consciousness, use of restraints, ventilator mode, pH, ventilator changes within the past 24 hours, and APACHE score. Bivariate association with the outcome variable was completed for each independent variable. Of these, only the variables described as &ocirc;level of consciousness&ouml; and &ocirc;previous UEx&ouml; were found to be related statistically to UEx. Logistic regression analysis was completed and no statistical relationship among any of the independent variables was demonstrated. Further analysis of the outcome variable demonstrated that of those who had unplanned extubations, 62% were not reintubated. One can therefore conclude from the lack of significant predictors for UEX in this population, as well as the low frequency of reintubation, that accurate assessment would have been fundamental in the prevention of UEx in this sample. Data collected from this study suggests that clinicians focus their intervention on the assessment of intubated patients and the start of a weaning protocol in order to initiate a planned extubation. Further studies including a larger sample size are warranted in attempts to identify clear predisposing factors of unplanned extubations.</td></tr></table>en_GB
dc.date.available2011-10-26T14:21:24Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T14:21:24Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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