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Cho and Yeo: Risk Factors for Deliberate Self-extubation
Original Article

Journal of Korean Academy of Nursing 2014; 44(5): 573-580.

Published online: 31 October 2014

DOI: https://doi.org/10.4040/jkan.2014.44.5.573

Risk Factors for Deliberate Self-extubation

Young Shin Cho1, Jung Hee Yeo2

1Surgical Intensive Care Unit, Kosin University Gospel Hospital, Busan, Korea.

2Department of Nursing, Dong-A University, Busan, Korea.

Address reprint requests to: Yeo, Jung Hee. Department of Nursing, Dong-A University, 32 Daesingongwon-ro, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2784, Fax: +82-51-240-2920, jheeyeo@dau.ac.kr

Received 3 July 2014       Revised 11 July 2014       Accepted 12 September 2014

© 2014 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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.

Keywords: Airway extubation, Survival analysis, Intensive care units

Figures and Tables

Figure 1
Kaplan-Meier survival curve for factors related to deliberate self-extubation.
jkan-44-573-g001
Table 1
Characteristics related to Deliberate Self-extubation of the Participants (N=450)
jkan-44-573-i001

*was measured by Workload Management System for Critical Care Nurses; D(S)E=Deliberate (self) extubation; ICU=Intensive care unit.

Table 2
Risk Factors for Deliberate Self-extubation (N=450)
jkan-44-573-i002

ICU=Intensive care unit; HR=Hazard ratio; CI=Confidence interval.

Notes

This manuscript is a condensed from of the first author's master's thesis from Dong-A University.

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