{"id":"https://openalex.org/W2941006100","doi":"https://doi.org/10.1542/peds.2018-0897","title":"Reduction in Unintended Extubations in a Level IV Neonatal Intensive Care Unit","display_name":"Reduction in Unintended Extubations in a Level IV Neonatal Intensive Care Unit","publication_year":2019,"publication_date":"2019-04-26","ids":{"openalex":"https://openalex.org/W2941006100","doi":"https://doi.org/10.1542/peds.2018-0897","mag":"2941006100","pmid":"https://pubmed.ncbi.nlm.nih.gov/31028159"},"language":"en","primary_location":{"id":"doi:10.1542/peds.2018-0897","doi":"https://doi.org/10.1542/peds.2018-0897","is_oa":false,"landing_page_url":"https://doi.org/10.1542/peds.2018-0897","pdf_url":null,"source":{"id":"https://openalex.org/S77494981","display_name":"PEDIATRICS","issn_l":"0031-4005","issn":["0031-4005","1098-4275"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","erih-plus","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315734","host_organization_name":"American Academy of Pediatrics","host_organization_lineage":["https://openalex.org/P4310315734"],"host_organization_lineage_names":["American Academy of Pediatrics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5027893034","display_name":"John Galiote","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I193531525","display_name":"George Washington University","ror":"https://ror.org/00y4zzh67","country_code":"US","type":"education","lineage":["https://openalex.org/I193531525"]},{"id":"https://openalex.org/I4210139747","display_name":"Virginia Hospital Center","ror":"https://ror.org/04fq6zd17","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210139747"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"John P. Galiote","raw_affiliation_strings":["Departments of Neonatology,","The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia","Virginia Hospital Center, Arlington, Virginia; and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departments of Neonatology,","institution_ids":[]},{"raw_affiliation_string":"The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia","institution_ids":["https://openalex.org/I193531525"]},{"raw_affiliation_string":"Virginia Hospital Center, Arlington, Virginia; and","institution_ids":["https://openalex.org/I4210139747"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061385904","display_name":"Michelande Ridor\u00e9","orcid":"https://orcid.org/0000-0002-7163-4751","observed_orcids":["https://orcid.org/0000-0002-7163-4751"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Michelande Ridor\u00e9","raw_affiliation_strings":["Departments of Neonatology,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departments of Neonatology,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040389822","display_name":"Jessica Carman","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1336742384","display_name":"Children's National","ror":"https://ror.org/03wa2q724","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1336742384"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jessica Carman","raw_affiliation_strings":["Neonatal Intensive Care Unit, Children\u2019s National Health System, Washington, District of Columbia;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neonatal Intensive Care Unit, Children\u2019s National Health System, Washington, District of Columbia;","institution_ids":["https://openalex.org/I1336742384"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050869744","display_name":"Lisa Zell","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1336742384","display_name":"Children's National","ror":"https://ror.org/03wa2q724","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1336742384"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Lisa Zell","raw_affiliation_strings":["Neonatal Intensive Care Unit, Children\u2019s National Health System, Washington, District of Columbia;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neonatal Intensive Care Unit, Children\u2019s National Health System, Washington, District of Columbia;","institution_ids":["https://openalex.org/I1336742384"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033530260","display_name":"Karen Brant","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Karen Brant","raw_affiliation_strings":["Respiratory Therapy, and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Respiratory Therapy, and","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057675770","display_name":"Cheyenne Gayle","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Cheyenne Gayle","raw_affiliation_strings":["Respiratory Therapy, and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Respiratory Therapy, and","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5070712701","display_name":"Billie Lou Short","orcid":"https://orcid.org/0000-0002-6785-9069","observed_orcids":["https://orcid.org/0000-0002-6785-9069"]},"institutions":[{"id":"https://openalex.org/I193531525","display_name":"George Washington University","ror":"https://ror.org/00y4zzh67","country_code":"US","type":"education","lineage":["https://openalex.org/I193531525"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Billie L. Short","raw_affiliation_strings":["Departments of Neonatology,","The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departments of Neonatology,","institution_ids":[]},{"raw_affiliation_string":"The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia","institution_ids":["https://openalex.org/I193531525"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079176674","display_name":"Darren Klugman","orcid":"https://orcid.org/0009-0008-4814-5723","observed_orcids":["https://orcid.org/0009-0008-4814-5723"]},"institutions":[{"id":"https://openalex.org/I193531525","display_name":"George Washington University","ror":"https://ror.org/00y4zzh67","country_code":"US","type":"education","lineage":["https://openalex.org/I193531525"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Darren Klugman","raw_affiliation_strings":["Pediatric Critical Care Medicine and Pediatric Cardiology, and","The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pediatric Critical Care Medicine and Pediatric Cardiology, and","institution_ids":[]},{"raw_affiliation_string":"The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia","institution_ids":["https://openalex.org/I193531525"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5000518845","display_name":"Lamia M. Soghier","orcid":"https://orcid.org/0000-0002-0597-1397","observed_orcids":["https://orcid.org/0000-0002-0597-1397"]},"institutions":[{"id":"https://openalex.org/I193531525","display_name":"George Washington University","ror":"https://ror.org/00y4zzh67","country_code":"US","type":"education","lineage":["https://openalex.org/I193531525"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Lamia Soghier","raw_affiliation_strings":["Departments of Neonatology,","The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departments of Neonatology,","institution_ids":[]},{"raw_affiliation_string":"The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia","institution_ids":["https://openalex.org/I193531525"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5000518845"],"corresponding_institution_ids":["https://openalex.org/I193531525"],"apc_list":null,"apc_paid":null,"fwci":2.568,"has_fulltext":false,"cited_by_count":21,"citation_normalized_percentile":{"value":0.88227365,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"143","issue":"5","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.9477999806404114,"subfield":{"id":"https://openalex.org/subfields/3604","display_name":"Emergency Medical Services"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.9477999806404114,"subfield":{"id":"https://openalex.org/subfields/3604","display_name":"Emergency Medical Services"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10549","display_name":"Neonatal Respiratory Health Research","score":0.02370000071823597,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.006899999920278788,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/neonatal-intensive-care","display_name":"neonatal intensive care","score":0.7770000100135803},{"id":"https://openalex.org/keywords/quality-improvement","display_name":"quality improvement","score":0.5249999761581421},{"id":"https://openalex.org/keywords/extubation-prevention","display_name":"extubation prevention","score":0.7360000014305115},{"id":"https://openalex.org/keywords/patient-positioning","display_name":"patient positioning","score":0.9179999828338623},{"id":"https://openalex.org/keywords/high-risk-patient-identification","display_name":"high-risk patient identification","score":0.5410000085830688},{"id":"https://openalex.org/keywords/reintubation","display_name":"reintubation","score":0.8560000061988831},{"id":"https://openalex.org/keywords/neonatal-morbidity","display_name":"neonatal morbidity","score":0.5389999747276306}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9276608228683472},{"id":"https://openalex.org/C119060515","wikidata":"https://www.wikidata.org/wiki/Q1916617","display_name":"Interquartile range","level":2,"score":0.668839693069458},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.5508567690849304},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.4753303825855255},{"id":"https://openalex.org/C2780317896","wikidata":"https://www.wikidata.org/wiki/Q2703","display_name":"Epoch (astronomy)","level":3,"score":0.425167441368103},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.407683402299881},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.18046167492866516},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.0},{"id":"https://openalex.org/C150846664","wikidata":"https://www.wikidata.org/wiki/Q7602306","display_name":"Stars","level":2,"score":0.0},{"id":"https://openalex.org/C1276947","wikidata":"https://www.wikidata.org/wiki/Q333","display_name":"Astronomy","level":1,"score":0.0},{"id":"https://openalex.org/C121332964","wikidata":"https://www.wikidata.org/wiki/Q413","display_name":"Physics","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000046","descriptor_name":"Academic Medical Centers","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D000046","descriptor_name":"Academic Medical Centers","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007223","descriptor_name":"Infant","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007231","descriptor_name":"Infant, Newborn","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007363","descriptor_name":"Intensive Care Units, Neonatal","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D007363","descriptor_name":"Intensive Care Units, Neonatal","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true},{"descriptor_ui":"D007442","descriptor_name":"Intubation, Intratracheal","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D007442","descriptor_name":"Intubation, Intratracheal","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D058996","descriptor_name":"Quality Improvement","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D058996","descriptor_name":"Quality Improvement","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true},{"descriptor_ui":"D060666","descriptor_name":"Airway Extubation","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D060666","descriptor_name":"Airway Extubation","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1542/peds.2018-0897","doi":"https://doi.org/10.1542/peds.2018-0897","is_oa":false,"landing_page_url":"https://doi.org/10.1542/peds.2018-0897","pdf_url":null,"source":{"id":"https://openalex.org/S77494981","display_name":"PEDIATRICS","issn_l":"0031-4005","issn":["0031-4005","1098-4275"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","erih-plus","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315734","host_organization_name":"American Academy of Pediatrics","host_organization_lineage":["https://openalex.org/P4310315734"],"host_organization_lineage_names":["American Academy of Pediatrics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"journal-article"},{"id":"pmid:31028159","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/31028159","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":22,"referenced_works":["https://openalex.org/W113703237","https://openalex.org/W1784229439","https://openalex.org/W1948857070","https://openalex.org/W1964171682","https://openalex.org/W1968285004","https://openalex.org/W1971687560","https://openalex.org/W1973446164","https://openalex.org/W1974990431","https://openalex.org/W1975554536","https://openalex.org/W2037731606","https://openalex.org/W2073575422","https://openalex.org/W2122231156","https://openalex.org/W2143733679","https://openalex.org/W2157202423","https://openalex.org/W2286795606","https://openalex.org/W2326426946","https://openalex.org/W2398165075","https://openalex.org/W2414887259","https://openalex.org/W2583269152","https://openalex.org/W2615171882","https://openalex.org/W2619064490","https://openalex.org/W3172986746"],"related_works":["https://openalex.org/W3093566471","https://openalex.org/W4414575829","https://openalex.org/W4405385609","https://openalex.org/W3016202605","https://openalex.org/W4378802124","https://openalex.org/W3168685681","https://openalex.org/W4401826267","https://openalex.org/W3163336235","https://openalex.org/W3089732006","https://openalex.org/W3149653407"],"abstract_inverted_index":{"OBJECTIVES:":[0],"Unintended":[1],"extubations":[2],"(UEs)":[3],"lead":[4],"to":[5,18,134,147,166],"significant":[6],"morbidity":[7],"in":[8,16,21,90,97,217,239],"neonates.":[9],"A":[10,215],"quality":[11,66],"improvement":[12,67],"project":[13,45],"was":[14,188,233],"initiated":[15],"response":[17],"high":[19],"rates":[20,32,141],"our":[22],"level":[23],"IV":[24],"NICU.":[25],"We":[26],"targeted":[27],"creating":[28],"and":[29,57,83,88,102,109,155,208,224,228],"sustaining":[30],"UE":[31,76,122,140,200,218,245],"below":[33,219],"the":[34,120,183],"published":[35],"standard":[36,65],"of":[37,75,79,104,185,196,241],"1":[38,52,70],"per":[39,149],"100":[40,150],"ventilator":[41,151],"days.":[42],"METHODS:":[43],"This":[44,231],"spanned":[46],"4":[47],"time":[48,116,184],"periods:":[49],"baseline,":[50],"epoch":[51,58,153],"(December":[53],"2010-May":[54],"2012),":[55],"sustain,":[56],"2":[59,93,163],"(May":[60],"2015-December":[61],"2017)":[62],"by":[63,143,176,226,236],"using":[64],"methodology.":[68],"Epoch":[69,92,162],"interventions":[71,94,164],"included":[72,95],"real-time":[73],"analysis":[74],"events,":[77],"standardization":[78,227],"taping,":[80],"patient":[81],"positioning":[82],"movement,":[84],"accurate":[85],"event":[86,110,187],"reporting,":[87],"change":[89],"nomenclature.":[91],"reduction":[96,238],"daily":[98],"chest":[99],"radiographs":[100],"(CXRs)":[101],"development":[103],"a":[105,159,167,205,211,237],"high-risk":[106],"tool.":[107],"Patient":[108],"characteristics":[111],"were":[112,156],"statistically":[113],"compared":[114],"across":[115],"points.":[117],"RESULTS:":[118],"Of":[119],"612":[121],"events":[123],"recorded":[124],"over":[125],"10":[126],"years,":[127],"249":[128],"UEs":[129],"occurred":[130],"from":[131],"May":[132],"2011":[133],"2017":[135],"involving":[136],"184":[137],"unique":[138],"patients.":[139],"decreased":[142,175],"43%":[144],"(from":[145],"1.75":[146],"0.99":[148],"days;":[152],"1)":[154],"sustained":[157,225],"until":[158],"notable":[160],"spike.":[161],"led":[165],"further":[168],"31%":[169],"rate":[170],"reduction.":[171],"Single":[172],"CXR":[173],"use":[174,240],"half.":[177],"Median":[178],"corrected":[179],"gestational":[180],"age":[181],"at":[182],"an":[186,199],"35":[189],"weeks":[190],"(interquartile":[191],"range:":[192],"29-41).":[193],"Seventy":[194],"percent":[195],"infants":[197],"experiencing":[198],"required":[201],"reintubation,":[202],"29%":[203],"had":[204,210],"previous":[206],"event,":[207],"9%":[209],"code":[212],"event.":[213],"CONCLUSIONS:":[214],"decrease":[216],"benchmarks":[220],"can":[221],"be":[222],"achieved":[223],"mitigation":[229],"interventions.":[230],"decline":[232],"also":[234],"accompanied":[235],"CXRs":[242],"without":[243],"increasing":[244],"events.":[246]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":3},{"year":2024,"cited_by_count":8},{"year":2023,"cited_by_count":1},{"year":2022,"cited_by_count":3},{"year":2021,"cited_by_count":2},{"year":2020,"cited_by_count":1},{"year":2019,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2019-05-03T00:00:00"}