2.50
Hdl Handle:
http://hdl.handle.net/10755/183040
Category:
Abstract
Type:
Presentation
Title:
Reduce Unplanned Extubation in Adult Critical Care Unit
Author(s):
Twiss, Betty; Milam, W.
Author Details:
Betty Twiss, RN, MSN, CCRN, Munroe Regional Medical Center, Ocala, FL, email: BettyTwiss@mrhs.org; W. Milam
Abstract:
Purpose: The purpose of this project is to minimize/prevent unplanned extubations. Unplanned extubation is defined as any accidental or purposeful removal of the endotracheal tube by a patient. Unscheduled extubation is recognized as a complication of mechanical ventilation that has the potential to result in bodily injury or death. Self-extubating patients have a longer ICU and hospital stay. Method: To use the "Plan-Do-Check-Act Cycle" to reduce or prevent unplanned extubations. Plan: Review of literature and an update of form used to report an unplanned extubation. Do: Collect data on every patient who had an unplanned, self-extubation. Check/Study: All information and data was evaluated to trend causes and patterns of self-extubation. An expert in this field was consulted and helped with data review. Act: Education of staff on potential causes and change current practice. Finding: Data review revealed a lack of pain medication being used at the time of weaning. As sedation was weaned to prepare for extubation, nurses were withholding pain medication as well for fear of its sedative effect. With the recent introduction of Intensivist to our unit, our weaning process had become more rapid. With this change, our self-extubations increased as a result of our patients waking up in pain. Once this problem was identified, our staff was re-educated about pain control and appropriate use of pain medication during the weaning process. As a result, our self-extubations decreased going from 8 in July to 2 in August and down to 0 in September. Discussion: An unplanned extubation is a potentially life-threatening incident that can lead to hemodynamic and airway instability as well as increase in length of stay and cost. Using Plan-Do-Check-Act Cycle, a literature review was conducted, Unplanned Extubation Report Form was updated and data collected. Through use of self- collected data, an inadequate level of pain control during the sedation weaning process was noted to be a causative factor in our increase in self-extubation. Through data reporting and communication with staff, perceptions were clarified, current practice changed and our self-extubations showed a steady decline. Quality and patient safety were enhanced and improved.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2010
Conference Name:
7th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Naples, Florida, USA
Description:
7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, 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.titleReduce Unplanned Extubation in Adult Critical Care Uniten_GB
dc.contributor.authorTwiss, Bettyen_US
dc.contributor.authorMilam, W.en_US
dc.author.detailsBetty Twiss, RN, MSN, CCRN, Munroe Regional Medical Center, Ocala, FL, email: BettyTwiss@mrhs.org; W. Milamen_US
dc.identifier.urihttp://hdl.handle.net/10755/183040-
dc.description.abstractPurpose: The purpose of this project is to minimize/prevent unplanned extubations. Unplanned extubation is defined as any accidental or purposeful removal of the endotracheal tube by a patient. Unscheduled extubation is recognized as a complication of mechanical ventilation that has the potential to result in bodily injury or death. Self-extubating patients have a longer ICU and hospital stay. Method: To use the "Plan-Do-Check-Act Cycle" to reduce or prevent unplanned extubations. Plan: Review of literature and an update of form used to report an unplanned extubation. Do: Collect data on every patient who had an unplanned, self-extubation. Check/Study: All information and data was evaluated to trend causes and patterns of self-extubation. An expert in this field was consulted and helped with data review. Act: Education of staff on potential causes and change current practice. Finding: Data review revealed a lack of pain medication being used at the time of weaning. As sedation was weaned to prepare for extubation, nurses were withholding pain medication as well for fear of its sedative effect. With the recent introduction of Intensivist to our unit, our weaning process had become more rapid. With this change, our self-extubations increased as a result of our patients waking up in pain. Once this problem was identified, our staff was re-educated about pain control and appropriate use of pain medication during the weaning process. As a result, our self-extubations decreased going from 8 in July to 2 in August and down to 0 in September. Discussion: An unplanned extubation is a potentially life-threatening incident that can lead to hemodynamic and airway instability as well as increase in length of stay and cost. Using Plan-Do-Check-Act Cycle, a literature review was conducted, Unplanned Extubation Report Form was updated and data collected. Through use of self- collected data, an inadequate level of pain control during the sedation weaning process was noted to be a causative factor in our increase in self-extubation. Through data reporting and communication with staff, perceptions were clarified, current practice changed and our self-extubations showed a steady decline. Quality and patient safety were enhanced and improved.en_GB
dc.date.available2011-10-28T16:11:59Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:11:59Z-
dc.conference.date2010en_US
dc.conference.name7th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationNaples, Florida, USAen_US
dc.description7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, 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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