Effectiveness of Implementing Clinical Nursing Practice Guidelines for Prevention of Unplanned Endotracheal Extubations in Medical Intensive Care Unit , Suratthani Hospital
Keywords:
Clinical nursing practice guidelines, Unplanned endotracheal extubations, Profession nurse satisfactionAbstract
Unplanned endotracheal extubations is a common complication in critically ill patients and is a life threatening situation. Prevention is necessary to adhere to the guidelines to achieve the desired outcomes. This operational study was to study the effectiveness of implementing clinical nursing practice guidelines(CNPGs) for prevention of Unplanned endotracheal extubations in medical intensive care unit 1(MICU1), Suratthani hospital, Suratthani province, and the satisfaction of the nurses. The target population is all patients who come to use the service in the MICU1 and received oral intubation by dividing the sample into 2 groups. 80 intubated critically ill patient who were confined in MICU1 before implementation of CNPGs and 96 intubated critically ill patient who were confined in MICU1 during implementing of CNPGs.The instrument used in this study was the clinical nursing practice guidelines for prevention of Unplanned endotracheal extubations which consists of 2 main components, Category 1 Assessment of extubations risk and Category 2 practice in order to prevent unplanned endotracheal extubations consisting of 7 activities 1) Providing information 2) Effective communication 3) Endotracheal suction
4) Effective fixing of endotracheal 5) Weaning of the ventilator 6) Pain assessment and management 7) Using appropriate physical restraint
The results of this study showed that the sample group that came to use during the CNPGs had 7.52 incident /1000 Endotracheal tube days which was less than the sample who come to the service before CNPGs with 11.90 incident /1000 Endotracheal tube days. The findings of this study confirm that implementation clinical nursing practice guidelines (CNPGs) for prevention of Unplanned endotracheal extubations in medical intensive care unit 1(MICU1) could reduce incident rate of unplanned endotracheal extubations. So this CNPGs will be used to improve the quality of care for critically ill patient with endotracheal intubation.
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