Effectiveness of patient care system development on the incidence of unplanned extubation in adult patients in the adult intensive care unit, Wanornnivas Hospital.

Abstract

     This study was an action research to develop and evaluate the effectiveness of a patient care system on the incidence of unplanned extubation (UE) in adult patients in the adult intensive care unit (ICU) at Wanornnivas Hospital. The population in this study was 24 adult patients with endotracheal intubation in the adult intensive care unit (ICU) at Wanornnivas Hospital. The risk assessment approach was based on the Motor Activity Assessment Scale (MASS) score and the PDCA (Plan-Do-Check-Act) process. The developed approach included risk assessment of unplanned extubation, effective communication, weaning from the ventilator, pain assessment, and appropriate restraint. The study was conducted between October 2024 and December 2024. The results were analyzed using paired t-test and independent t-test.
     The results of the study found that nursing staff had the highest opinion on the feasibility of implementing the guidelines. The study of the problem found that patients with high MASS scores (5.0 and above) were at the highest risk of UE, and UE occurred at 25% in patients with high MASS scores (5.0 and above), while patients with low MASS scores (2.0-4.0) had no UE events. In terms of care outcomes, the average duration of intubation after development was reduced by 1.2 days in all patients.