Comparison of two endotracheal tube securement techniques on unplanned extubation, oral mucosa, and facial skin integrity

Objective: To determine the effect of 2 standard methods (ie, twill tape versus adhesive tape) of securement on unplanned extubation, oral mucosa, and facial skin integrity of the orally intubated patient. Design: A prospective, quasi-experimental design was used for the pilot study. Setting: The setting for the pilot study included critical care units of 3 community hospitals and 1 veterans’ hospital in a midwestern city. Subjects: A total of 52 orally intubated adult subjects were enrolled in the study from the 4 clinical sites over a 6-month period of time. The participants in the study consisted of 30 men and 22 women. The subjects ranged in age from 22 to 85 years, with a mean age of 62.3 years. The mean length of intubation was 89.6 hours. Outcome Measures: The outcome measures of the study were (1) unplanned extubation, (2) oral mucosa status, and (3) facial skin integrity. Interventions: Endotracheal tube securement with either the twill tape or the adhesive tape securement method. Results: With use of multiple analysis of variances (MANOVA) and repeated analyses of variances (ANOVAs), there were no significant differences by time or type of endotracheal tube securement method on oral mucosa or facial skin integrity. A chi-square analysis demonstrated no significant association between the 2 types of endotracheal tube securement when comparing their efficacy in preventing unplanned extubation. Conclusion: The findings of this pilot study demonstrated both methods of endotracheal tube securement to be comparable in preventing unplanned extubation and in maintaining oral mucosa status and facial skin integrity. (Heart Lung® 1998;27:409-17)