Poster Presentation

Friday, July 13, 2007
9:30 AM - 10:15 AM

Friday, July 13, 2007
3:15 PM - 4:00 PM
This presentation is part of : Poster Presentation III
Discussion of Factors Regarding the Patient Self-extubation of Endotracheal Tube in Surgical Intensive Care Unit – From a Teaching Hospital in Southern Taiwan
Yuan-Ting Huang, RN, MSN, Yung Ming, RN, MSN, and Wen-Chiung Yu, RN, MSN. Nursing Department, Kaohsiung Armed Forces General Hospotal, Kaohsiung, Taiwan
Learning Objective #1: evaluate the patient’s condition of oxygenation indeed to prevent self-extubation for the training session of weaning.
Learning Objective #2: provide practice experience of nursing care to decrease the incident events and to improve the quality of nursing.

The aim of this research was to discuss the factors regarding the patient self-removal of Endotracheal Tube (ETT), and explore the differences between the group of patients who have or have not self-removed ETT.  The case study was performed between January and December of 2005.  139 subjects were recruited, from a teaching hospital in southern Taiwan, based on purpose sampling.  The subjects were selected from 44 patients who have self-removed the ETT and 654 patients whose ETT had been removed by medical staffs after examination and evaluation.  The result demonstrates the rate of patient self-removal of ETT is 6.4%; the illness of the subject (APACH II) was relative low (10.86; SD=7.24).  Among the subjects, 29% came from the department of Neuro-surgery. 63.9% of the patients had used restrains, 66.7% of the post-surgical patients was not given sedation.  The analysis of the two groups demonstrated that significant variables include three categories: departments which the patients were recruited from (P<0.001), whether the patients were at the stage of being extubated (p<0.001) and age (p<0.05).  Further analysis with Multiple Logistic Regression demonstrates that “whether the patients are at the stage of being extubated” is a main variable that determines the self-removal of ETT.  It was then discovered in the 44 patients who have self-removed ETT, 28 of them were in the stage of extubation, among these, 70% of the patients were not sedated and 81.8% of the self-removed ETT patients are conscientious of the act.  30.43% of the patients self-removed ETT within a day, 80% of patients were successful, and 93.2% of the patients did not incur any adverse effects.  The result shows that the medical staff should firmly evaluate the patients’ condition of oxygenation, decrease the training session for patients of extubation and advance the time of extubation to prevent self-extubation.