Knowledge, attitudes, and practices of nurses in preventing unplanned extubation of orotracheal intubation in the adult intensive care unit: a multicenter questionnaire survey

Background: Endotracheal intubation is a common procedure performed in the intensive care unit (ICU), which can lead to life-threatening outcomes. Aim: To understand the knowledge, attitudes, and practices, as well as influence factors, on nurses for unplanned extubation prevention in patients with orotracheal intubation in intensive care unit. Study design: A total of 698 ICU nurses from 26 tertiary hospitals were enrolled in January 2022. Their knowledge, attitudes, and practices (KAP) of unplanned extubation prevention were collected. Results: The KAP scores were 3.31 ± 1.50, 166.94 ± 23.83, and 126.88 ± 16.43, respectively, and the scoring rates for these dimensions were 33.07, 90.24, and 87.50%, respectively. The standard score for knowledge was 33.07 ± 15.03. Multivariate linear regression analysis revealed that while years of experience and region were statistically significant factors, they explained only a small proportion of the variance in KAP scores, suggesting that other unmeasured factors also play an important role. Nurses with ≤5 years of clinical experience had poorer knowledge than those with >5 years of clinical experience. Nurses at hospitals located in the plateau region had poorer KAP regarding unplanned extubation than those in the plain region. Albeit with regional and experience-dependent variations, most nurses had positive attitudes for unplanned extubation prevention, but their knowledge and practices require improvements. Conclusion: The survey indicated that the attitude, and practice levels regarding unplanned orotracheal extubation among ICU nurses were moderate, suggesting significant room for improvement. Notably, knowledge scores were relatively low, particularly among nurses in plateau regions, highlighting the necessity of prioritizing training in this area.