Construction and validation of unplanned endotracheal extubation management strategies for oral tracheal intubation in adult ICU patients
PAN Shiqin
SUN Xiaolin
MA Qin
HAN Jinhai
SUN Lijuan
LU Yanping
TONG Yaqian
LUO Yincong
Abstract：Objective:To establish optimal evidence for preventing unplanned endotracheal extubation in adult patients undergoing endotracheal intubation in the intensive care unit(ICU),apply it to clinical practice,and evaluate its effectiveness.Methods:The PIPOST framework was used to define evidence-based practice questions.A search strategy and search terms were developed to retrieve,synthesize,and assess the clinical appropriateness of evidence,thereby identifying optimal practice evidence.Review indicators were then established,baseline reviews conducted,implementation barriers analyzed,and change strategies formulated.Compare the rate of unplanned extubation through oral tracheal intubation in adult ICU patients before and after the application of the best evidence,the implementation of various review indicators by ICU nursing staff,and the changes in the knowledge,attitude and practice level of ICU nursing staff in prevention of accidental oral intubation dislodgement in adult patients.Results:After evidence implementation,the rate of unintentional endotracheal tube dislodgenment among ICU patients decreased from 0.92%to 0.25%,but the difference was not statistically significant(P>0.05).Implementation rates of all indicators except Indicator 11 improved following evidence-based practice.Nurses'total scores for knowledge,attitude,and practice regarding preventing unplanned endotracheal extubation in adult ICU patients receiving endotracheal intubation increased,with all differences statistically significant(P<0.05).Conclusion:Evidence-based preventive management strategies effectively enhance ICU nurses'clinical practice implementation capabilities and knowledge-attitude-practice levels.Although the improvement in unplanned endotracheal extubation rates did not reach statistical significance,the overall approach positively contributes to enhancing nursing quality.
Keywords：oral endotracheal intubationunplanned extubationbarriers factorsbaseline reviewknowledgeattitudeand practiceevidence-based nursing
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：9( 701-709 )