重症患者非计划性拔管的分析及预见性护理

Nation unscheduled extubation in critical patients and its predictive nursing care

目的分析重症患者非计划性拔管的原因，探讨其预见性护理措施。方法回顾分析2012年6月至2012年12月发生的35例非计划性拔管病例，查找原因，并制定预防措施，2013年1月至2013年6月采取预见性护理，两组资料进行对照分析，比较两组非计划性拔管的发生率。取预见性的护理措施，包括护理素质的提高、有效的管道固定方法、管道标示及评估记录要求的建立、护理操作的规范等。结果实施预见性护理后非计划性拔管的发生率明显下降，实施前的拔管率为6．8％（35／518），实施后的拔管率为3．5％（16／460），差异具有统计学意义（P〈0．05）。结论通过实施预见性护理措施预防非计划性拔管的发生，重症患者非计划性拔管的发生率明显降低，有力保障了患者的生命安全。

Objective To investigate the causes of unscheduled extubation in critical patients and explore its predictive nursing care. Methods 35 critical patients extubated unscheduledly from June, 2012 to December, 2012 were retrospectively analyzed to find the causes and formulate some preventive measures. January, 2013 to June, 2013, predictive nursing care was carried out. The incidences of unscheduled extubation in both groups were compared. Predictive nursing measures included improving nursing quality, effective methods fixing tube, tube marking, establishing evaluation requirement, nursing operation specification, etc. Results The incidence of unscheduled extubation was 6.8% before and was 3.5% after implementing predictive nursing care, with a statistical differenc, e （P 〈 0.05）. Conclusions Implementing predictive nursing measures can lower the incidence of unscheduled extubation in critical patients and guarantee the patients＇ life safety