Team Resource Management Strategy on Reducing Unplanned Extubation Events Rate of Endotracheal Tube

Cheng, Ciao-An

Purpose: The purpose of this study is to reduce the rate of unplanned endotracheal tube removal in ICU.In order to learn about the process of team resources management mode and how to plan decrease the the rate of unplanned endotracheal tube removal in order to protect patient's safety.

Methods: After cause analyzing from the 20 cases who were suffered unplanned endotracheal tube removal in ICU in 2011. The team resources management mode was utilized to build up certain interventions in order to improve this situation, such as leadership, situational monitoring, team supporting and communication.Thus,we plan in-service education.Establish the standard unplanned endotracheal tube removal.Plan I'M SAFE activity.Establish the partner system in clinical care.Innovate zero extubation by patient.Interprerfessional meeting take place for effectively to communicate the patient clinical care plan.

Results: After engaging interventions from January 2012 to May 2013, the rate of unplanned endotracheal tube removal has decreased from 0.27% in 2011 to 0.14% in 2012 by 12 cases. This reached the study goal.The zero extubation by patient from January 2012 to May 2013,we culculate the days no patient extubation by himself in the duration is achieve 104 days.The Interprerfessional meeting all participants attendance rate is 95%.

Conclusion: The endotracheal tube safety is the way to promote patient's safety and it also be serious problem for public health care system.This kind of patients care is focus on physycal restraint and protect the invasive tube.This study not only applied the team resources management mode to prevent unplanned endotracheal tube removal which had achieved significant positive result, but also increased patients’ safety.Besides, positive negotiation climate in working place had established through management strategy.This study obtain many special glory,and Iin our hospital that become a TRM pole with a trophy hung on it.This successful experience is expend to other hospital.We hope the team resources management mode can continue to promote patient's safety in order to provide excellent medical treatment quality.