[Answered]: I selected unplanned decannulation or…

I selected unplanned decannulation or self-extubation and accidental gastrostomy (G-tube) dislodgement as the primary clinical practice problems because the subacute facility where I will be precepting predominantly serves ventilator-dependent patients and those requiring long-term enteral feeding. In this setting, airway and feeding devices are central to daily care, and complications related to their management occur frequently and pose significant patient safety concerns. Unplanned decannulation or self-extubation is a critical patient safety issue associated with increased risk of hypoxia, respiratory distress, and unplanned transfers to higher levels of care. These events are often linked to modifiable risk factors such as agitation, inadequate securement, and inconsistent monitoring. Recent evidence demonstrates that nursing-led interventions, including standardized securement methods, structured risk assessments, and enhanced surveillance, can reduce the incidence of unplanned extubation (Han et al., 2025). Accidental G-tube dislodgement is another prevalent clinical issue in subacute care and may result in interruptions in nutrition and medication administration, increased infection risk, and avoidable hospitalizations. Variability in nursing practices related to tube securement and site assessment contributes to these events. Implementing standardized nursing care protocols significantly reduces G-tube dislodgement rates, highlighting the importance of evidence-based nursing practice (Kobzeva-Herzog et al., 2025).