2.50
Hdl Handle:
http://hdl.handle.net/10755/157048
Category:
Abstract
Type:
Presentation
Title:
A Collaborative Solution to Decrease Unplanned Extubations in the Intensive Care Unit
Author(s):
Schroeder, Susan L.; Faas, April
Author Details:
Susan L. Schroeder, RN,MSN,CCRN, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA, email: sschroeder@uwhealth.org; April Faas
Abstract:
PURPOSE: An unplanned extubation is a potentially life-threatening incident that could lead to hemodynamic and airway complications, and increased costs. Since 2005 the University of Wisconsin HospitalÆs 24-bed trauma and life support center has experienced an increased number of patients with unplanned extubations. A decision to implement eICU monitoring in the south side of the unit (12 beds) was made. One goal of the eICU monitoring was to minimize/prevent unplanned extubations. DESCRIPTION: In August 2008, eICU monitoring was implemented, which provided additional support to all patients, including intubated patients. e-Care registered nursesÆ interventions include video rounding assessment on all patients; reminding confused, agitated patients not to pull on tubes; responding to vital sign alerts; updating bedside staff of changes; reviewing patientsÆ medications for potential causes of confusion and notifying staff if found; and monitoring confused patients for the bedside staff if staff are involved with other patients. The unit implemented additional strategies to decrease the number of unplanned extubations. Nursing leadership interviewed staff whose patient had an unplanned extubation to better understand the circumstances surrounding the event and educated bedside staff to increase their awareness of unplanned extubations. The multidisciplinary team ensures that standardized sedation and weaning protocols are implemented and continues early morning rounds, rounding first on patients with successful weaning trials in hope to expedite extubation for those patients. EVALUATION/OUTCOMES:Since August 2008 the number of unplanned extubations per 1000 ventilator days on the south side has shown a decline (5.2), whereas the number on the north side has continued to increase (11.2). Patient Safety Net reports on unplanned extubations with a harm score of D or E were tracked, and when compared to similar patients without an unplanned extubation, it was shown that these patients had an increased length of stay of 1.7 days at a cost of $5487. Seventeen patients on the north side experienced an unplanned extubation and were assigned a harm score of D or E. On the south side during the same period only 8 patients experienced an unplanned extubation. This difference represents a potential cost saving of $49500.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleA Collaborative Solution to Decrease Unplanned Extubations in the Intensive Care Uniten_GB
dc.contributor.authorSchroeder, Susan L.en_GB
dc.contributor.authorFaas, Aprilen_GB
dc.author.detailsSusan L. Schroeder, RN,MSN,CCRN, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA, email: sschroeder@uwhealth.org; April Faasen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157048en
dc.description.abstractPURPOSE: An unplanned extubation is a potentially life-threatening incident that could lead to hemodynamic and airway complications, and increased costs. Since 2005 the University of Wisconsin HospitalÆs 24-bed trauma and life support center has experienced an increased number of patients with unplanned extubations. A decision to implement eICU monitoring in the south side of the unit (12 beds) was made. One goal of the eICU monitoring was to minimize/prevent unplanned extubations. DESCRIPTION: In August 2008, eICU monitoring was implemented, which provided additional support to all patients, including intubated patients. e-Care registered nursesÆ interventions include video rounding assessment on all patients; reminding confused, agitated patients not to pull on tubes; responding to vital sign alerts; updating bedside staff of changes; reviewing patientsÆ medications for potential causes of confusion and notifying staff if found; and monitoring confused patients for the bedside staff if staff are involved with other patients. The unit implemented additional strategies to decrease the number of unplanned extubations. Nursing leadership interviewed staff whose patient had an unplanned extubation to better understand the circumstances surrounding the event and educated bedside staff to increase their awareness of unplanned extubations. The multidisciplinary team ensures that standardized sedation and weaning protocols are implemented and continues early morning rounds, rounding first on patients with successful weaning trials in hope to expedite extubation for those patients. EVALUATION/OUTCOMES:Since August 2008 the number of unplanned extubations per 1000 ventilator days on the south side has shown a decline (5.2), whereas the number on the north side has continued to increase (11.2). Patient Safety Net reports on unplanned extubations with a harm score of D or E were tracked, and when compared to similar patients without an unplanned extubation, it was shown that these patients had an increased length of stay of 1.7 days at a cost of $5487. Seventeen patients on the north side experienced an unplanned extubation and were assigned a harm score of D or E. On the south side during the same period only 8 patients experienced an unplanned extubation. This difference represents a potential cost saving of $49500.en_GB
dc.date.available2011-10-26T19:22:31Zen
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:22:31Zen
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en
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