Risk Factors for Deliberate Self-extubation.
10.4040/jkan.2014.44.5.573
- Author:
Young Shin CHO
1
;
Jung Hee YEO
Author Information
1. Surgical Intensive Care Unit, Kosin University Gospel Hospital, Busan, Korea.
- Publication Type:Original Article ; English Abstract
- Keywords:
Airway extubation;
Survival analysis;
Intensive care units
- MeSH:
Age Factors;
Aged;
Consciousness;
Device Removal;
Female;
Humans;
Hypnotics and Sedatives/therapeutic use;
Intensive Care Units;
Intubation, Intratracheal/mortality/*nursing/psychology;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Nurses/statistics & numerical data/supply & distribution;
Proportional Hazards Models;
Psychomotor Agitation;
Retrospective Studies;
Risk Factors;
Workload
- From:Journal of Korean Academy of Nursing
2014;44(5):573-580
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. METHODS: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. RESULTS: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). CONCLUSION: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.
