2.50
Hdl Handle:
http://hdl.handle.net/10755/182407
Category:
Abstract
Type:
Presentation
Title:
Reducing Unplanned Extubations in the Pediatric Intensive Care Unit
Author(s):
Bossard, Alicia
Author Details:
Alicia Bossard, RN, BSN, CPN, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, USA, email: c5amb1@carilion.com
Abstract:
Unplanned Extubation (UEX) is defined as the removal of an endotracheal tube (ETT) without the advanced planning of the healthcare team. It can be a serious complication of mechanically ventilated patients. Our healthcare team noted that during the winter of 2007/2008 we had an increased amount of UEX in our Pediatric Intensive Care Unit (PICU). As a result, a multidisciplinary taskforce was created to evaluate the incidence of UEX and the factors surrounding them. Preventive measures to reduce UEX were developed in a nurse driven process. We conducted a literature review relative to UEX & implemented evidence-based best practice guidelines for the management of children with ETTs. We identified 5 steps to decrease UEX: Sedation, Restraint Use and Positioning, ETT Taping and Stabilization, Pt. Weights, and Huddling. Sedation protocols and order sets were developed by our physicians with collaboration from staff nurses. Education was provided to nursing, respiratory, and radiology staff to include specific guidelines for ETT taping/stabilization and bedside presence during x-ray. Restraint measures were reviewed and deemed appropriate. This education was received well and the staff worked together cohesively to maintain these guidelines. Evidence-based articles were made available for staff to review. When a UEX occurred we gathered additional data to track & monitor progress. The incidence of UEX has decreased 60% since education and implementation of these guidelines. We conclude that these specific practice changes have been successful in reducing the number of UEX in our PICU. References: Marcin, J. (2007). Unplanned Extubations - They're not accidental. Pediatric Critical Care Medicine, 8 (4) 406-407.; Ream, R. Mackey, K. et al. (2007). Association of nursing workload and unplanned extubations in a pediatric intensive care unit. Pediatric Critical Care Medicine, 8 (4) 366-371.; Sadowski R, Dechert R, et al. (2004). Continuous Quality Improvement: Reducing Unplanned Extubations in a Pediatric Intensive Care Unit. Pediatrics, 114 (3) 628-632.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2009
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Louisville, Kentucky, USA
Description:
"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, 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_US
dc.typePresentationen_GB
dc.titleReducing Unplanned Extubations in the Pediatric Intensive Care Uniten_GB
dc.contributor.authorBossard, Aliciaen_US
dc.author.detailsAlicia Bossard, RN, BSN, CPN, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, USA, email: c5amb1@carilion.comen_US
dc.identifier.urihttp://hdl.handle.net/10755/182407-
dc.description.abstractUnplanned Extubation (UEX) is defined as the removal of an endotracheal tube (ETT) without the advanced planning of the healthcare team. It can be a serious complication of mechanically ventilated patients. Our healthcare team noted that during the winter of 2007/2008 we had an increased amount of UEX in our Pediatric Intensive Care Unit (PICU). As a result, a multidisciplinary taskforce was created to evaluate the incidence of UEX and the factors surrounding them. Preventive measures to reduce UEX were developed in a nurse driven process. We conducted a literature review relative to UEX & implemented evidence-based best practice guidelines for the management of children with ETTs. We identified 5 steps to decrease UEX: Sedation, Restraint Use and Positioning, ETT Taping and Stabilization, Pt. Weights, and Huddling. Sedation protocols and order sets were developed by our physicians with collaboration from staff nurses. Education was provided to nursing, respiratory, and radiology staff to include specific guidelines for ETT taping/stabilization and bedside presence during x-ray. Restraint measures were reviewed and deemed appropriate. This education was received well and the staff worked together cohesively to maintain these guidelines. Evidence-based articles were made available for staff to review. When a UEX occurred we gathered additional data to track & monitor progress. The incidence of UEX has decreased 60% since education and implementation of these guidelines. We conclude that these specific practice changes have been successful in reducing the number of UEX in our PICU. References: Marcin, J. (2007). Unplanned Extubations - They're not accidental. Pediatric Critical Care Medicine, 8 (4) 406-407.; Ream, R. Mackey, K. et al. (2007). Association of nursing workload and unplanned extubations in a pediatric intensive care unit. Pediatric Critical Care Medicine, 8 (4) 366-371.; Sadowski R, Dechert R, et al. (2004). Continuous Quality Improvement: Reducing Unplanned Extubations in a Pediatric Intensive Care Unit. Pediatrics, 114 (3) 628-632.en_GB
dc.date.available2011-10-28T15:22:53Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:22:53Z-
dc.conference.date2009en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationLouisville, Kentucky, USAen_US
dc.description"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, USA.en_US
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.-
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