Unplanned extubations in an intensive care unit: Findings from a critical incident technique

Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses
Matteo DanielisAlvisa Palese

Abstract

Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. To gain a greater understanding of the antecedents of unplanned extubations. A qualitative study design involving the critical-incident technique. A total of 10 registered nurses who reported one or more episodes of unplanned extubations were involved in an in-depth interview. According to the nurses' experience, episodes of unplanned extubations are determined by predisposing, precipitating and mediating factors. The predisposing factors have been recognised in the (a) weaning programme (expected/unexpected decreased sedation) and in the (b) patient factors (increased needs due to discomfort, restlessness and desire to communicate). The precipitating factors have been divided into (a) organisational (failures in multi-professional communication), (b) environmental (excessive environmental cha...Continue Reading

Citations

Dec 22, 2019·International Journal of Nursing Studies·Matteo DanielisAnne Lucia Leona Destrebecq
Feb 11, 2021·Revista brasileira de enfermagem·Giovanna Mercado TorresSabrina Guterres da Silva Galetto

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