Analysis of Risk Factors and Nursing Strategies for Unplanned Extubation in Children: Retrospective Cohort Study.
Xuefeng Han, Hairong Liu, Tingchong Zhang and 1 others
PMID 40493515WHAT IT FOUND
Thirteen unplanned extubations occurred over six years in a pediatric surgery ward.
Most happened to boys under three, during holidays, and when nurses were not at the bedside. Urinary and gastric tubes were the most common culprits.
Key findings
01Infants and toddlers under three years old accounted for 61.6% of unplanned extubation cases, and boys were 2.3 times more likely to be affected than girls.
0292.3% of incidents happened when nurses were not at the bedside, and 69.2% occurred during holidays rather than business days.
03Urinary catheters caused 61.5% of events, while gastric tubes had the highest incidence rate per 1000 catheter days.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size of 13 unplanned extubation events is extremely small, limiting the generalizability of the findings. The study was conducted in a single center, which may not reflect practices in other hospitals. Exclusion criteria did not account for neurodevelopmental disorders or atopic predisposition, which could confound results. The study did not quantify dynamic nurse-to-patient ratios, only noting whether a nurse was present at the bedside.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the high percentage of events occurring when nurses were absent as proof that constant bedside monitoring prevents all extubations. With only 13 total cases, this pattern could easily be due to chance, and the study design cannot prove that adding more nurse presence would reduce the rate.