The authors describe how they developed and instituted a new policy and procedure for unplanned extubations, updated an existing policy and procedure, and were successful in decreasing the number of unplanned extubations in their institution.

Endotracheal intubation is done many times a day in hospitals for patients who have or may have a problem with their airway. Once a patient is intubated, maintenance of the endotracheal tube is essential. In critical care units, the task of maintaining tube patency and placement is the responsibility of nursing and respiratory care professionals.

For as long as patients have been intubated, the potential for unplanned removal of the endotracheal tube has been a source of concern. This concern has led nurses and other medical professionals to search for ways to decrease the occurrence of unplanned extubation. Unplanned extubation is defined as any accidental or purposeful removal of the endotracheal tube by a patient....

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