儿童重症监护室非计划性拔管现状调查及分析

目的描述非计划性拔管在儿童重症监护室的现状及原因。方法2008年1—12月上海某三级甲等儿科医院中3个重症监护室发生非计划性拔管的患儿共21例，根据意外事件报告单，对发生非计划性拔管的原因进行系统分析。结果患儿的年龄、患儿身体约束不当、镇静不足、胶布固定无效和护理人力不足是造成患儿非计划性拔管的高危因素。结论非计划性拔管率是重症监护质量的重要指标，建立一套有效的预防非计划性拔管标准包括有效约束、有效胶布固定、有效的镇静，合理护理人力配置以及提高护士的评估能力将有助于降低非计划性拔管发生率，提升重症监护室的护理品质。

Investigation and analysis of unplanned extubation in pediatric intensive care units

Objective To describe the current situation and causes of unplanned extubation in pediatric intensive care units. Methods Twenty-one children underwent unplanned extubation in three intensive care units from January 2008 to December 2008 were investigated in our hospital. The accident report cards were collected and the causes of unplanned extubation were analyzed systematically. Results High risk factors causing unplanned extubation included the children＇s age, inappropriate restraint, inadequate sedation, ineffective sticking plaster and inadequate nursing staffing. Conclusion The occurrence of unplanned extubation is an important indicator of critical care quality. It is essential that a guideline preventing unplanned extubation should be established. Effective restraint, adequate sedation, effective sticking plaster and adequate nursing staffing are helpful to reduce the occurrence of unplanned extubation and to improve the nursing quality of critical care.