J Korean Acad Nurs.  2014 Oct;44(5):573-580. 10.4040/jkan.2014.44.5.573.

Risk Factors for Deliberate Self-extubation

• Cho YS
• Yeo JH

• KMID: 2129547
• DOI: http://doi.org/10.4040/jkan.2014.44.5.573

Abstract

PURPOSE
This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation.
METHODS
Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model.
RESULTS
Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients).
CONCLUSION
Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

Keyword

Airway extubation; Survival analysis; Intensive care units

MeSH Terms

Age Factors
Aged
Consciousness
Device Removal
Female
Humans
Hypnotics and Sedatives/therapeutic use
Intensive Care Units
Intubation, Intratracheal/mortality/*nursing/psychology
Kaplan-Meier Estimate
Male
Middle Aged
Nurses/statistics & numerical data/supply & distribution
Proportional Hazards Models
Psychomotor Agitation
Retrospective Studies
Risk Factors
Workload
Hypnotics and Sedatives

Figure

• 

  Figure 1 Kaplan-Meier survival curve for factors related to deliberate self-extubation.

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