Abstract: Objective: To evaluate continuous effects of cluster nursing strategy for preventing tracheal intubation unplanned extubation in adults outlined in the 2018 edition provides reference for clinical nursing decision-making for ICU nurses. Methods: From June to December 2018, the strategy was implemented in 11 selected hospitals in Tianjin and proved to be effective. Following its success, the strategy was then widely promoted throughout the city. Continuous tracking and evaluation of its effects were conducted for four consecutive years. Results: After the implementation of the project, from 2019 to 2022, the median rate of unplanned extubation remained at 0. However, the compliance rate of overall strategy execution and individual item execution showed fluctuations. In 2020 and 2021, two items were below the target value, and in 2022, two items were also below the target value. Other items achieved the target value. Conclusion: The content of the 2018 edition of cluster nursing strategy for preventing tracheal intubation unplanned extubation in adults is scientific, feasible and effective, and its popularization and application can improve the quality of nursing care, reduce the rate of unplanned extubation of tracheal intubation, and ensure the safety of patients.

Key words: unplanned extubation; tracheal intubation; evaluation; nursing quality; patient safety; continuous quality improvement