Effect of Clinical Nursing Practice Guideline for Prevention of Unplanned Extubation in Critically Ill Infant by CURN Model on Nurse Behavior and unplanned extubation

Main Article Content

Krittiyanee Panatthanang
Nilawarn Chanthapreeda

Abstract

       As action research, the purpose of this study was to develop and evaluate the implementation impacts of clinical nursing practice guidelines for prevention of unplanned extubation in critically ill infants based on the CURN Model. The period of study was from December 2017 to April 2018. The study was conducted from December 2017 to April 2018. The samples of this study were 30 nurses who all practiced in pediatric intensive care units and 30 infant patients who were on endotracheal tubes and using ventilators. The infants were selected by purposive sampling. The data was analyzed statistically by frequencies, percentages, means, and standard deviation. Then the mean scores of knowledge, attitude, and nursing practice between before and after the implementation were compared by Paired t-test procedure. The results of this study showed that 1. The clinical nursing practice guidelines for prevention of unplanned extubation in critically ill children by the CURN model are composed of 1) endotracheal intubation, 2) monitoring risk factors of unplanned extubation, and 3) weaning the ventilator together with the innovative “Safety Bed,” 2) the average score of knowledge, attitude, and nursing practice for prevention of unplanned extubation in critically ill children were higher than before participation in the development programs with statistical significance (p-value < 0.05), and 3) the rate incidence of unplanned extubation was 0 accidental extubation/1000 patient intubation days. The findings indicate that the CURN Model promotes higher efficiency of nursing practice and prevention of unplanned extubation in critically ill infants.

Article Details

How to Cite
1.
Panatthanang K, Chanthapreeda N. Effect of Clinical Nursing Practice Guideline for Prevention of Unplanned Extubation in Critically Ill Infant by CURN Model on Nurse Behavior and unplanned extubation. Health Sci J Thai [Internet]. 2024 Oct. 25 [cited 2024 Dec. 14];6(4):87-94. Available from: https://he02.tci-thaijo.org/index.php/HSJT/article/view/264933
Section
Original articles

References

Angkana J. The development of clinical nursing practice guideline for prevention of accidental endotracheal tube extubation in neonate intensive care unit at MahasarakhamHospital. [Dissertation]. Khon Kean: Khon Kean University; 2014. (in Thai)

Jitra S. The development of clinical nursing practice guideline for prevention of accidental endotracheal tube extubation in pediatric intensive care unit at Photharam Hospital.[Internet].2009[cited2018 October 10] Available from http://www.photharamhosp.go.th/ptrhos/attachments/article/30/pdfd15.pdf.(in Thai)

Lucas da Silva PS, de Carvalho WB. Unplanned extubation in pediatric critically ill patients: Asystematic review and best practice recommendations. Pediatr Crit Care Med 2010; 11(2): 287-294.

Lamphun Hospital. Annual report of Lamphun Hospital fiscal year 2015. Lamphun province. Lamphun Provincial Health Office; 2558.(in Thai)

Ketsara S. Critical nursing care for respiratory system.Songkla:Faculty of Nursing Prince of Songkla University; 2008.(in Thai)

Phongam P, Wonginchan A. The effects of providing information about the hypothermia prevention guideline in preterm infants on the knowledge, attitude, and practice of nurses in the intermediate care unit. Journal of Nursing Science and Health 2024; 47(1): 26-39. (in Thai)

Burns N, Grove SK. The Practice of Nursing Research: Concept, Critique and Utilization. (4thed.). Philadelphia: W.B. Saunders.2005.

Yamane T. Statistics: An Introductory Analysis. 3rd Edition, Harper and Row, New York. 1973.

Piyanan P.The effects of clinical nursing practice guideline for prevention of unplanned extubation in neonate intensive care unit at loei Hospital.[Dissertation]. Khon Kean: Khon Kean University; 2008.(in Thai)

Yaowapa J.Development and Implementation of Clinical Practice Guidelines for Unplanned Endotracheal Extubation in Pediatric Intensive Care Unit, Nakornping Hospital, Chiang Mai. Journal of Nurses Association of Thailand, North-Eastern Division 2009; 27(4): 22-29.

Patcharee T. The effects of clinical nursing practice guideline for assessment of risk factor for unplanned extubation and suitable practice in pediatric intensive care unit at siriraj hospital.[Internet].2011[cited 2018 October 10] Available from http://hdl.handle.net/11228/3178. (in Thai)

Suwanya S. The effect of empowerment nursing practice guideline on preventing endotracheal tube displacement of newborn infant in neonatal intensive care unit at mahasarakham hospital. Mahasarakham Hospital Journal 2015; 12: 169-181. (in Thai)

Thanaporn A, Pailin N, Patson K, Wilailak S. The development of clinical nursing practice guideline for prevention of accidental endotracheal tube extubation in pediatric intensive care unit at sakonnakhon hospital. Journal of Sakon Nakhon Hospital 2013; 2: 20-30.(in Thai)

Kaufman J, Rannie M, Kahn MG, Vitaska M, Wathen B, Peyton C, et al. An interdisciplinary initiative to Reduce Unplanned Extubation in Pediatric Critical Care Units. Pediatrics 2012; 6: 1594-1600.

Meregalli CN, Jorro Baron FA, D’Alessandro MA, Danzi EP, Debaisi GE. Impact of a quality improvement intervention on the incidence of unplanned extubations in a pediatric intensive care unit. Arch Argent pediatric 2013; 5:391-397.

Marcin JP, Rutan E, Rapetti P, Brown JP, Rahnamay R, Pretzlaff RK. Nurse staffing and unplanned extubation in the pediatric intensive care unit. Pediat Criti Care Med 2005; 6(3): 254-257.

Fitzgerald RK, Davis AT, Hanson SJ. Multicenter analysis of the factors associated with unplanned extubation in the PICU. Pediatr Crit Care Med 2015; 16(7): e217-e223.

Razavi SS, Nejad RA, Mohajerani SA, Talebian M. Risk Factors of Unplannned Extubation in Pedaitric Intensive Care Unit. Tanaffos 2013; 12(3): 11-16.

Tripathi S, Nunez DJ, Katyal C, Ushay HM. Plan to Have No Unplanned : A Collaborative Hospital-Based Quality-Improvement Project to Reduce the Rate of Unplanned Extubations in the Pediatric ICU. Respiratory Care 2015; 60(8): 1105-1112.

Lucas da Silva PS, DeAguiar VE, Neb HM, DeCarvalho WB. Unplanned extubation in a pediatric intensive care unit: impact of a quality improvement program. Anaesthesia 2008; 63(12): 09-12.

Chisako M. Prevention strategies for unplanned extubation in NICU : A literature review. Journal of Neonatal Nursing 2016 ; 22: 91-102.

Rujira D, Duenpen T. The development of clinical nursing practice guideline for prevention of accidental endotracheal tube extubation in neonatal intensive care unit at Nakhonphanom hospital. Nakhonphanom Hospital Journal 2016; 3(2): 57-66.(in Thai)

Pilailak K, Saranya J, Namtip K, Pakamas J. Prevention of unplanned extubation in pediatric intensive care unit. Princess of Naradhiwas University Journal 2020; 12(1): 25-35. (in Thai)

Valeria CN, Camila GR, Bruno M, Elessandra B, Adriana K, Monica C, et al. Effectiveness of a bundle to prevent unplanned extubation in a pediatric intensive care unit: A multidisciplinary approach. Pediatric Dimensions 2020; 5: 1-5.