Counting unplanned extubations: marked variation among neonatologists.
J Perinatol
; 37(6): 698-701, 2017 06.
Article
en En
| MEDLINE
| ID: mdl-28151492
ABSTRACT
OBJECTIVE:
To assess if neonatologists detect and count unplanned extubations (UEs) uniformly. STUDYDESIGN:
An Institutional Review Board-exempted anonymous web-based survey of neonatology attending and fellow members of the AAP Neonatal-Perinatal Medicine section was administered. Respondents were queried on practices concerning UE; they were then presented with different case scenarios and asked if they would count the event as a UE.RESULTS:
Of the 509 respondents, 61% track UE rates. Of those who track UE rates, 53% reported rates of 1-3 per 100 ventilator days. The top two factors perceived as causing UEs were endotracheal tube (ETT) dislodgement by patient (65%) and failure of ETT holding system at attachment to the face (56%). In the various scenarios where ETT was urgently removed by staff, only 19 to 62% of respondents counted the event as a UE, including 23% if the ETT was removed by the attending. There was consensus on the scenarios representing self-extubation and elective change of the ETT.CONCLUSIONS:
There is wide variation in methods for detecting and counting UE events among neonatologists, which precludes comparison of UE rates across institutions. We speculate that a standardized definition and classification of events will enable benchmarking among neonatal intensive care units, which should accelerate collaborative improvement efforts towards reducing UEs in neonates.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Unidades de Cuidado Intensivo Neonatal
/
Remoción de Dispositivos
/
Extubación Traqueal
/
Neonatólogos
Límite:
Humans
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Perinatol
Asunto de la revista:
PERINATOLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos