Unplanned extubation in a paediatric intensive care unit: impact of a quality improvement programme.

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  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 0370524 Publication Model: Print Cited Medium: Internet ISSN: 1365-2044 (Electronic) Linking ISSN: 00032409 NLM ISO Abbreviation: Anaesthesia Subsets: MEDLINE
    • Publication Information:
      Publication: Oxford, UK : Wiley-Blackwell
      Original Publication: London, Academic Press; New York, Grune & Stratton.
    • Subject Terms:
      Device Removal* ; Quality Assurance, Health Care*; Intensive Care Units, Pediatric/*standards ; Intubation, Intratracheal/*instrumentation; Age Distribution ; Brazil ; Child, Preschool ; Equipment Failure ; Female ; Humans ; Infant ; Length of Stay ; Male ; Prognosis ; Program Evaluation ; Prospective Studies ; Respiration, Artificial
    • Abstract:
      Unplanned tracheal extubation is an important quality issue in current medical practice as it is a common occurrence in paediatric intensive care units. We have assessed the effectiveness of a continuous quality improvement programme in reducing the incidence of unplanned extubation over a 5-year period. After a 2-year baseline period, we developed action plans to address the issues identified. Following implementation of the programme, the overall incidence of unplanned extubation decreased from 2.9 unplanned extubations per 100 intubated patient days in the first year to 0.6 in the last year (p = 0.0001). This reduction was the result of a decrease in unplanned extubation in children younger than 2 years of age. Although mortality was similar to that of children who did not experience an unplanned extubation, those with an unplanned extubation had a significantly longer duration of mechanical ventilation, longer stay in the intensive care unit, and longer hospital stay. We found that the implementation of a continuous quality improvement programme is effective in reducing the overall incidence of unplanned extubations.
    • Publication Date:
      Date Created: 20081127 Date Completed: 20081210 Latest Revision: 20081126
    • Publication Date:
      20231215
    • Accession Number:
      10.1111/j.1365-2044.2008.05628.x
    • Accession Number:
      19032255