Abstract:

Objective To integrate the relevant original research,evidence-based guidelines and consensuses on the risk assessment tools for unplanned endotracheal extubations（UEE） in China and abroad. Methods Focusing on risk assessment tools for UEE,the authors systematically searched the Chinese and English databases and related guideline websites from the inception to March 1,2021. The extracted information included the author,the year,the country,the target population,the type of tool,the study method,the main assessment content and the high-risk threshold for UEE. Results 13 papers were eventually included,among which 11 were qualitative studies based on expert opinions such as Delphi and 2 were based on quantitative studies such as the case-control studies. The types of tools were categorised as risk assessment scales,risk assessment systems,risk assessment maps,and risk prediction models. Conclusion Patient and catheter factors are important parts of UEE risk assessments. There are various types of UEE risk assessment tools,but their reliability and validity need to be further tested by multi-centred and large-scale clinical application studies.

Key words: Endotracheal Tube, Unplanned Extubations, Risk Assessment, Tools, Scoping Review, Nursing Care

摘要：

目的 系统综述国内外与气管插管非计划拔管（unplanned endotracheal extubations,UEE）风险评估工具相关的原始文献、指南和专家共识。方法 聚焦UEE风险评估工具,系统检索中、英文数据库和指南网站,检索时限为建库至2021年3月1日。提取的信息包括作者、年份、国家、适用对象、工具类型、研究方法、主要评估内容和高危临界值。结果 最终纳入13篇文献,11篇为基于德尔菲法和专家会议法等定性研究方法的文献,2篇为基于病例对照等定量研究方法的文献,工具类型分为风险评估表、风险评估体系、风险评估图和风险预测模型。结论 患者因素和导管因素为UEE风险评估的重要内容。UEE风险评估工具的种类多样,但其信效度仍有待进一步检验,需要进一步开展多中心、大范围的临床应用研究。

关键词: 气管插管, 非计划拔管, 风险评估, 工具, 范围综述, 护理