The Effect of Clinical Nursing Practice on the Prevention of Unplanned Endotracheal Extubation in General Medical Wards, Phrae Hospital

Abstract

Background:   Developing clinical nursing practice to prevent unplanned endotracheal extubation is considered important because it can maximize the level of patient’s safety and the quality of nursing care.

Objective:     To investigate the effects of the utilization of clinical nursing practice on preventing unplanned endotracheal extubation in general medical wards, Phrae hospital.

Study design: Quasi-experimental was conducted during June-December 2012. Sample were 88 patients in general medical wards, Phrae hospital. Those were equally grouped into a controlled and experimental groups. Clinical nursing practices for unplanned endotracheal extubation was developed and applied to 44 patients of experimental group. Research instruments were record forms assessing data around incident in unplanned endotracheal extubation. Data were analyzed using an exact probability test, t-test, Wilcoxon rank-sum test, Chi-squared test, and multivariable rate ratio regression.

Results:         Rate of unplanned endotracheal extubation in a group with a clinical nursing practice for preventing unplanned endotracheal extubation was .02/1,000 patient days, while a group without clinical nursing practice reported .21/1,000 patient day. By multivariable rate regression, rate ratio of unplanned endotracheal extubation in a group without clinical nursing practice was 5.50 higher than that of an experimental group (p<.001).

Conclusion:  Clinical nursing practice for preventing unplanned endotracheal extubation is effective to minimize unplanned endotracheal extubation.

Keywords:     Patient’s ventilator care, Unplanned Endotracheal extubation, Clinical nursing

practice guideline