Factors promoting successful extubation: An audit of planned extubations in preterm infants following the implementation of nursing guidelines

Abstract 

Reintubation, following an unsuccessful extubation from mechanical ventilation is traumatic for the infant and the family. This paper examines the increased success rate of extubations in one tertiary unit following the introduction of nursing guidelines for extubation. In the sample of 19 babies, 17 remained extubated for more than 48 h. The discussions within this paper will examine factors such as the mode of ventilation that the babies were on prior to extubation, the timing of handling pre and post-extubation and the position that they were nursed in after removal of the endotracheal tube. There is also discussion around areas where the nursing guidelines were not adhered to, and the reasons as to why this might be. The conclusion though is that there is some tentative evidence to support the use of nursing guidelines to improve outcomes for infants, although this is based on a small study.

Keywords: Extubation, Interprofessional collaboration, Minimal handling, Positioning, Guidelines