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頁籤選單縮合
題名 | 成人加護病房非計劃性拔除氣管內管之相關因素探討=Factor Associated with Non-Planned Extubation of Endotracheal Tube in Adult Intensive Care Unit |
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作者 | 許素珍; 陳一伶; 柯德鑫; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 4:1 2002.01[民91.01] |
頁次 | 頁9-16 |
分類號 | 419.73 |
關鍵詞 | 成人加護病房; 氣管內管; 非計劃性拔管; Adult; Intensive care unit; Non-planned extubation; |
語文 | 中文(Chinese) |
中文摘要 | 本研究的目的在探討非計劃性氣管内管拔除病患之相關影響因素。以臺灣南部某醫學中心成人加護病房民國88年1月1日至88年12月31日接受氣管内管照護且在加護病房内有拔管紀錄之病患541人為研究對象,以護理部品管委員會擬定之「加護病房病人管路自拔/滑脫報告表」為資料收集工具,採事後回溯研究法登錄病歷内之資料,而後依病患拔管方式分為非計劃組與計劃組以χ²、t-test、logistic regression進行資料分析。結果發現:1.研究對象中非計劃組有100人(共125次),另441人(632次)為計劃組,非計劃拔管率為9.85%;2.兩組間男性、意識狀態較清楚、初插管24小時内、呼吸器之PEEP使用壓力較高、拔管前24小時動脈血液pH值<7.35與PCO₂≧50 mmHg、有約束或使用鎮靜劑者非計劃性比率較高;3.夜班發生非計劃性拔管較高;4.非計劃性拔管後24小時内重新插管之比率較高。上述研究發現可提供預防非計劃性拔管之參考,以提昇護理品質。 |
英文摘要 | The objective of this study is to evaluate factors associated with non-planned extubation of endotracheal tube. We retrospectively reviewed medical record of adult patients admitted to intensive care unit (ICU) at a Southern Taiwan medical center between January 1st 1999 and December 31st 1999. These who fulfilled our case definition were recruited for present study. We used the questionnaire developed by the quality control committee of the Department of Nursing to collect data and the statistical software SPSS for data analysis. Five hundred and forty-one subjects were recruited. Among them, one hundred subjects totally experienced 125 episodes (9.85%) of non-planned extubation of endotracheal tube. We found factors associated with a higher rate of non-planned extubation induced male in gender, a clearer conscious level at extubation, a higher positive end expiratory pressure (PEEP) at extubation, arterial blood pH value less than 7.35 and PCO2 greater than or equal to 50 mmHg 24 hours before the extubation event, history of been retrained, and use of sedatives. The non-planned extubation occurred more frequently in the first 24 hours after intubation. The non-planned extubation group had a higher re-intubation rate within 24 hours after the extubation event. Non-planned extubation was more frequently occurred during nighttime shift. The finding of this study would provide information to prevent occurrence of non-planned extubation in intensive care unit. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。