20例患者非计划性拔管原因分析及护理对策

目的:探讨住院患者非计划拔管的相关因素,减少此类护理不良事件的发生,确保护理安全。方法:对2013年1月~2013年9月我院发生20例非计划性拔管的不良事件进行回顾分析,查找发生原因和特点,制定确实可行的防范措施。结果:20例非计划性拔管患者初中或以下学历17例,占85%;男性17例,占85%;意识不清、烦躁患者11例,占55%;尿管、胃管、气管插管3种管道非计划性拔管18例,占90%;ICU、肿瘤中心、神经内科发生14例,占70%;烦躁患者约束不当或未约束9例,占45%;固定方法单一15例,占75%;无并发症18例,占90%;家属知情并理解17例,占85%。结论:防范非计划性拔管的发生需加强医护与患者及家属的沟通,护理人员在日常工作中对患者及家属的宣教至关重要。

Analysis of the causes and nursing countermeasures of 20 patients with unplanned extubation

Objective：Through the investigation about the causes of in-patients with unplanned extubation, to reduce the adverse events of nursing and to confirm the nursing safety.Methods By the review analysis of 20 cases of the adverse events with unplanned extubation from In January 2013 to September 2013, to find the causes and characteristics and formulate really feasible preventive measures.Results From 20 cases with unplanned extubation, the patients of the Junior high school or below,the males,the unconsciousness and be agitated were respective 17 cases（85%）, 17 cases （85%） and 11 cases（ 55% ） ; the proportion of urine tube, stomach tube and endotracheal intubation with unplanned extubation accouted for 90%（ 18cases）; Intensive Care Unit （ICU）,Cancer Center and Neurology Department added up to 14 cases（70%）; Agitated patients who constrained improper way or no constraint were 9 cases （45%）; Patients of Single fixed method and no complications were respective 15 cases （75%）, 18 cases （90%）;Patients whose relatives knew and understood were 17 cases, accounting for 85%.Conclusions To prevent the unplanned extubation,we should strengthen communication between petients and their relatives and it is very important to strengthen education of petients and their relatives by nursing staff in daily work.