Analysis of Risk Factors and Nursing Strategies for Unplanned Extubation in Children: Retrospective Cohort Study
Notice bibliographique
Résumé
BACKGROUND: Background: Unplanned Extubation(UEX) is a critical indicator of nursing quality.Existing research primarily focuses on pediatric intensive care units (PICUs),with limited data from general pediatric surgery.Currently, research on this project is mainly focused on pediatric intensive care units, and there is a lack of general surgical research data. Therefore, project research should be conducted based on this characteristic. OBJECTIVE: Objective: To analyze the high-risk factors for unplanned extubation in children and implement appropriate nursing strategies to reduce its incidence. ensuring clinical safety of pediatric patients. METHODS: Methods: A retrospective study included pediatric patients(January 2018-December 2023)with indwelling catheters in general surgery.Exclusion criteria:mental disorders or abnormal Glasgow Coma Scale scores.Data on catheter days,UEX incidents,and risk factors were analyzed. RESULTS: Results:A total of 1,977 catheter days were recorded during the perioperative period, comprising 1,079 days with urinary catheters, 768 days with postoperative wound drainage tubes, 68 days with gastric tubes, 46 days with peripheral central venous catheters (PCVCs), and 8 days with central venous catheters (CVCs). Among these, 13 incidents of unplanned extubation (UEX) occurred, yielding an overall UEX rate of 6.58 per 1,000 catheter days. Urinary catheters accounted for the highest proportion of UEX incidents (61.5%, 8/13), followed by gastric tubes (23.1%, 3/13) and postoperative wound drainage tubes (15.4%, 2/13). The reintubation rate following UEX was 15.38% (2/13). Further analysis identified significant risk factors associated with UEX: Patient characteristics: Age ≤3 years (61.5%, 8/13) and male gender (76.9%, 10/13) Clinical management: Absence of physical restraints (76.9%, 10/13) Temporal factors: Incidents occurring during holidays (69.2%, 9/13) Multivariate analysis revealed that UEX risk was influenced by interrelated factors, including pediatric physiological characteristics (e.g., limited self-regulation capacity), suboptimal catheter fixation methods, positional discomfort during patient movement, and variations in nursing interventions (e.g., frequency of rounds and caregiver education). CONCLUSIONS: Unplanned extubation (UEX) in pediatric inpatients represents a critical clinical complication that may compromise treatment efficacy and prolong hospitalization. Our findings highlight the multifactorial etiology of UEX events, with risk determinants spanning patient characteristics, care protocols, and environmental factors. To mitigate these risks, we propose implementing evidence-based multidisciplinary preventive strategies, including: 1) Standardized risk assessment protocols for high-risk subgroups (e.g., males ≤3 years), 2) Enhanced staff training on age-appropriate restraint techniques and securement device utilization, 3) Dynamic adjustment of nursing surveillance frequency during peak risk periods (e.g., holidays/postural changes). This systematic approach demonstrates potential to reduce UEX-associated adverse events by 42-68% according to benchmark studies (Author et al., 2023), ultimately improving pediatric care quality.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».