Impact of a quality improvement intervention on the incidence of unplanned extubations in a Pediatric Intensive Care Unit. / Impact of a quality improvement intervention on the incidence of unplanned extubations in a Pediatric Intensive Care Unit.

ABSTRACT

INTRODUCTION: An unplanned extubation (UEX) is a frequent and preventable adverse event of mechanical ventilation. OBJECTIVES: To fnd out the causes of unplanned extubation and assess the use of a quality improvement intervention to reduce this event rate. POPULATION Patients with invasive mechanical ventilation for more than 12 hours over the period from May 1st 2010 and April 30th 2011 in a Pediatric Intensive Care Unit (PICU). DESIGN: Uncontrolled, before and after study. A quality improvement intervention was used over the period between November 2010 and April 2011, which included training PICU staff, establishing standards to fx the endotracheal tube and control its fxation. RESULTS: There were 395 patients admitted to the PICU, 262 (66