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Reporting the incidence of unplanned extubation in the neonatal intensive care unit
Author(s) -
Aydon Laurene,
Zimmer Margo,
Sharp Mary
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13850
Subject(s) - medicine , incidence (geometry) , audit , neonatal intensive care unit , emergency medicine , mechanical ventilation , intubation , gestational age , endotracheal intubation , pediatrics , pregnancy , anesthesia , physics , management , biology , optics , economics , genetics
Aim The aim of this study was to highlight the incidence of unplanned extubation (UE) and identify associated factors in our neonatal population. Methods This study was a prospective audit. Results A specifically designed audit tool was used to capture UE events; 182 neonates required mechanical ventilation for 863 days. There were 41 episodes of UE. The UE rate was 4.75 per 100 days of ventilation. At the time of UE, median gestational age of patients was 27.3 weeks (23.4–37.6), with a corrected age median of 29.2 weeks (23.4–37.6). Re‐intubation was required in two thirds of the patients for increasing apnoea and increased work of breathing. Endotracheal tubes are secured in a standardised way either using Neobar or brown tape. UE events occurred with both methods. The two most common factors associated with UE included active handling of the baby and the time of day (0700–1000 h). Conclusions This audit has provided our neonatal intensive care unit with a benchmark for improvement. It has also created staff awareness of the risk of UE and promoted staff engagement to reduce UE. A bundle approach to reduce UE has been introduced. Future audits are planned to monitor the impact of these initiatives.