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Department
Nursing
Degree Name
Doctor of Nursing Practice (DNP)
Abstract
A significant number of preterm neonates require the placement of an endotracheal tube for invasive mechanical ventilation, which increases morbidity. The inadvertent displacement of the endotracheal tube, known as unplanned extubation (UE), increases the morbidities associated with intubation. Available literature shows UE rates less than 1 per 100 ventilator days decreases the risk of long-term complications associated with UE such as bronchopulmonary dysplasia and retinopathy of prematurity. This can be accomplished by implementing standardized care bundles to guide staff in caring for intubated babies to prevent UE. A Midwestern level 3 neonatal intensive care unit with high rates of unplanned extubation had no interventions in place to reduce the frequency of their occurrence. A Quality Improvement project to implement a care bundle for standardization of care of intubated neonates was hypothesized to decrease the rate of plan exhibition within the unit. Using a convenience sample of all intubated neonates, a total of 3000 ventilator days were accounted for over the course of one year using qualitative analysis. The implementation of a standardized care bundle led to a decrease in the rate of UE, and the three months post intervention were below the goal rate of 1/100. The care bundle was made part of the standard care treatment for intubated infants, minimizing the risks associated with UE in future patients.
Keywords
neonates, unplanned extubation, mechanical ventilation, care bundle
Advisor
Jenny Manry
Date of Award
Spring 2025
Document Type
DNP Project
Recommended Citation
Bless, Stacey, "Reducing Uplanned Extubation in the NICU" (2025). Master's Theses or Doctor of Nursing Practice. 3283.
Available at:
https://scholars.fhsu.edu/theses/3283
Rights
© The Author
