Analysis of Risk Factors and Nursing Strategies for Unplanned Extubation in Children: Retrospective Cohort Study

Unplanned extubation in pediatric inpatients represents a critical clinical complication that may compromise treatment efficacy and prolong hospitalization. Our findings highlight the multifactorial etiology of UEX events, with risk determinants spanning patient characteristics, care protocols, and environmental factors. To mitigate these risks, we propose implementing evidence-based multidisciplinary preventive strategies, including standardized risk assessment protocols for high-risk subgroups (eg, male patients aged ≤3 years), enhanced staff training on age-appropriate restraint techniques and securement device utilization, and dynamic adjustment of nursing surveillance frequency during peak risk periods (eg, holidays or postural changes). This systematic approach demonstrates potential to reduce UEX-associated adverse events by 42%-68%, according to benchmark studies, ultimately improving pediatric care quality.