Construction and application of the evaluation index system of unplanned extubation prevention etfect in children with critical endotracheal intubation-assisted ventilation
Objective To construct an evaluation index system of unplanned extubation prevention etfect in children with critical endotracheal intubation-assisted ventilation by using the Delphi method and to test the effect through clinical application.Methods The primary item pool of evaluation indicators for the prevention effect of unplanned extubation in children with critical endotracheal intubation-assisted ventilation was constructed through literature analysis,and the indicators were screened and revised through Delphi method expert consultation.The evaluation index system for the prevention effect of unplanned extubation in children with critical endotracheal intubation-assisted ventilation was formed eventualty.Taking the critically ill children with tracheal intubation-assisted ventilation admitted to the hospital as the study object,51 cases from June 2020 to June 2021 were taken as the control group(before the implementation of the evaluation index system),and 51 cases from July 2021 to June 2022 were taken as the observation group(after the implementation of the evaluation index system).The incidence of unplanned extubation and the quality of care were compared between the two groups.Results The recovery rate of the first and second round of questionnaires was 100％,the expert authority coefficients were 0.872 and 0.885,the Kendall harmonic coefficients were 0.383 and 0.428,respectively.The final formed indicator system included 3 primary indicators,9 secondary indicators,35 tertiary indicators,and the index variation coefficient was 0.06～0.16.The results showed that the incidence of unplanned extubation in the observation group was 5.88％,which was lower than the 19.6％in the control group,and the difference was statistically significant(P＜0.05).The scores of patients in the observation group for each dimension of the nursing quality evaluation scale were greater than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion The evaluation index system of unplanned extubation prevention effect for children with severe tracheal intubation-assisted ventilation based on Delphi method is relatively complete and reliable,the application of the index system in clinical care can continuously improve the quality of unplanned extubation prevention care and reduce the incidence rate of unplanned extubation.
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