Abstract:

Objective　To explore the application value of pipeline slip risk assessment form in the prevention of unplanned extubation in intensive care unit (ICU). Methods　A total of 100 patients treated with indwelling catheter in ICU, Guangzhou Chest Hospital from May 2022 to April 2023 were selected as the research subjects. They were divided into a control group and an observation group by the random number table method with 50 cases in each group. The control group included 39 males and 11 females, aged (55.10±29.06) years. The observation group included 35 males and 15 females, aged (55.10±29.06) years. The control group was treated with routine ICU nursing measures, and the observation group was treated with a risk assessment table for pipeline slip based on routine nursing. The risk assessment was carried out when the patients were admitted to the department, and targeted pipeline management was carried out after identifying different risk groups. The rate of unplanned extubation and the occurrence of catheter accidents in ICU were compared between the two groups. t test and χ² test were used. Results　The unplanned extubation rates of tracheal intubation (0), gastric tube [2.0% (1/50)], central venous catheter (0), and urinary catheter [4.0% (2/50)] in the observation group were lower than those in the control group [8.51% (4/47), 14.00% (7/50), 8.33% (4/48), and 18.00% (9/50)], with statistically significant differences (χ²=4.265, 4.891, 4.259, and 5.005; P=0.039, 0.027, 0.039, and 0.025). The incidences of catheter blockage [4.0% (2/50)], catheter distortion [8.0% (4/50)], catheter displacement [6.0% (3/50)], and catheter related infection (0) in the observation group were lower than those in the control group [16.0% (8/50), 24.0% (12/50), 20.0% (10/50), and 8.0% (4/50)], with statistically significant differences (χ²=4.000, 4.762, 4.332, and 4.167; P=0.046, 0.029, 0.037, and 0.041). Conclusion　The pipeline slip risk assessment form can help medical staff identify high-risk populations for unplanned extubation, and its application in ICU nursing can effectively reduce the rate of unplanned extubation and reduce the occurrence of catheter hidden dangers, which is worth promoting and applying.

Key words:

ICU, Unplanned extubation, Pipeline slip risk assessment form, Preventive nursing

摘要：

目的　探究管道滑脱风险评估表在重症监护室（ICU）非计划性拔管防范中的应用价值。方法　选择2022年5月至2023年4月在广州市胸科医院ICU留置管道治疗的100例患者作为研究对象，采用随机数字表法分为对照组和观察组，各50例。对照组男39例，女11例，年龄（55.10±29.06）岁；观察组男35例，女15例，年龄（55.10±29.06）岁。对照组采用常规ICU护理措施，观察组在常规护理基础上引入管道滑脱风险评估表，即患者入科时进行风险评估，识别不同风险人群进行针对性管道管理。比较两组患者在ICU住院期间非计划性拔管率、导管意外事件发生状况。采用t检验、χ²检验。结果　观察组气管插管（0）、胃管［2.0%（1/50）］、中心静脉导管（0）、尿管［4.0%（2/50）］非计划性拔管率均低于对照组［8.51%（4/47）、14.00%（7/50）、8.33%（4/48）、18.00%（9/50）］，差异均有统计学意义（χ²=4.265、4.891、4.259、5.005，P=0.039、0.027、0.039、0.025）。观察组导管堵塞［4.0%（2/50）］、导管扭曲［8.0%（4/50）］、导管移位［6.0%（3/50）］、导管相关性感染（0）发生率均低于对照组［16.0%（8/50）、24.0%（12/50）、20.0%（10/50）、8.0%（4/50）］，差异均有统计学意义（χ²=4.000、4.762、4.332、4.167，P=0.046、0.029、0.037、0.041）。结论　管道滑脱风险评估表可帮助医护人员识别非计划性拔管高危人群，将其应用于ICU护理中能够有效降低非计划性拔管率，减少导管隐患事件发生，值得推广应用。

关键词:

重症监护室, 非计划性拔管, 管道滑脱风险评估表, 预防护理