综合ICU近三年不良事件中非计划性拔管的原因分析与护理对策

Cause Analysis and Nursing Countermeasures of Unplanned Extubation in Adverse Events in Comprehensive ICU in Recent Three Years

目的对综合ICU近三年不良事件中非计划性拔管事件的原因进行分析,寻求护理对策,以期降低非计划性拔管的护理风险,提高患者的医疗安全。方法对厦门大学附属第一医院综合ICU于2019年1月—2021年12月收治的患者中发生的非计划性拔管事件进行回顾性分析,从患者、护士、导管、科室管理等几个方面的因素中进行数据收集及统计学分析。结果年龄≥70岁、文化程度较低的危重患者更易发生非计划性拔管;低年资护士尤其是男性护士发生拔管的机率更高。结论通过对非计划性拔管的事件进行分析,寻找护理对策,落实重点环节管理,为降低拔管风险提供重要依据。加强对低年资护士的培训及考核,提高护士整体的风险意识及护理质量,从而降低非计划性拔管的风险,保证患者安全。

Objective To analyze the causes of unplanned extubation in the adverse events of comprehensive ICU in recent three years,and seek nursing countermeasures,in order to reduce the nursing risk of unplanned extubation and improve the medical safety of patients.Methods Retrospective analysis was made on unplanned extubation events occurred in the comprehensive ICU of the First Affiliated Hospital of Xiamen University from January 2019 to December 2021.Data collection and statistical analysis were conducted from patients,nurses,catheters,department management.Results Unscheduled extubation was more likely to occur in critically ill patients with age≥70 years and lower education level;low seniority nurses,especially male nurses,are more likely to have decannulation.Conclusion Through the analysis of unplanned extubation events,nursing countermeasures and implementing key link management can provide an important basis for reducing the risk of extubation.Strengthen the training and assessment of junior nurses,improve the overall risk awareness and comprehensive quality level of nurses,strive to reduce the risk of unplanned extubation and ensure the safety of patients.