Effectiveness of a Nurse Competency Enhancement Program on Reducing the Incidence of Unplanned Extubation in Critically Ill Medical Patients: A Comparative Study with 4-Year Retrospective Data
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Abstract
This quasi-experimental study aimed to evaluate the effectiveness of a professional nursing competency enhancement program for preventing unplanned extubation (UE) among critically ill medical patients. Specifically, the study compared the incidence of UE after program implementation with four-year retrospective data and examined changes in professional nursing competency before and after participation in the program. The sample comprised 14 registered nurses and 100 mechanically ventilated critically ill patients, including 50 patients before and 50 patients after program implementation. Participants were selected according to predetermined criteria. The program was developed based on Bandura’s Self-Efficacy Theory and consisted of nine competency-enhancing activities. The research instruments demonstrated satisfactory content validity (IOC = 0.96) and reliability (ICC = 0.84). Data were analyzed using descriptive statistics, paired t-test, and Exact Poisson test.
The findings showed that the incidence of UE after program implementation was 1.92 events per 1,000 ventilator days, which was lower than the incidence reported in the four-year retrospective data (9.32–13.68 events per 1,000 ventilator days). In addition, professional nursing competency significantly increased after participation in the program (p < 0.001), and all nurses met the competency evaluation criteria.
The results suggest that the professional nursing competency enhancement program effectively improved nurses’ competency in preventing unplanned extubation and contributed to reducing the incidence of UE among critically ill medical patients. The program may be applied to enhance the quality and safety of nursing care in medical intensive care units.
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