中华护理杂志 ›› 2019, Vol. 54 ›› Issue (1): 19-24.

• 论著 • 上一篇    下一篇

减少ICU患者身体约束的循证护理实践

徐燕 石卫琳 郎黎薇 施培红 杨晓莉 曹艳佩   

  1. 复旦大学附属华山医院
  • 出版日期:2019-01-15 发布日期:2019-01-15

Evidence-based nursing practice and evaluation of effects for reducing physical restraint among patients in ICUs

  • Online:2019-01-15 Published:2019-01-15

摘要: 目的 应用基于循证的最佳实践证据以减少ICU身体约束的使用。方法 应用循证护理的方法获取最佳实践证据,并采用澳大利亚JBI的临床证据实践应用系统将最佳实践证据应用于本院各ICU,共110张床位,比较应用前后ICU身体约束使用率及身体约束使用不正确率。结果 采用循证干预措施前后,ICU身体约束使用率分别为40.89%和30.23%,差异具有统计学意义(P<0.05);ICU身体约束使用不正确率从33.12%降到7.48%,差异具有统计学意义(P<0.05);非计划性拔管率分别为3.12%和2.94%。结论 通过循证护理干预,可进一步规范身体约束的使用,在不增加意外拔管风险的前提下,可有效降低ICU身体约束使用率和约束使用不正确率。

关键词: 循证护理学, 重症监护病房, 约束, 身体的

Abstract: Objective To explore interventions based on best evidence for reducing physical restraint among patients in ICUs and to evaluate effects of interventions. Methods The best evidence-based interventions were obtained by adopting evidence-based nursing procedures and were implemented in the ICUs with 110 beds. This project was guided by the Joanna Briggs Institute (JBI) Practice Application of Clinical Evidence System (PACES). The rates of using physical restraint and incorrect practice of physical restraint before and after the implementation were compared. Results After implementation of the evidence-based interventions (the year 2015 v.s. the year 2017),the rate of using physical restraint was decreased from 40.89% to 30.23%,and the difference was statistically significant (P<0.05). The rate of incorrect practice of physical restraint was reduced from 33.12% to 7.48%,and the difference was statistically significant(P<0.05). Meanwhile,the rate of unplanned extubation before and after implementation was 3.12% and 2.94% "respectively. Conclusion The evidence-based nursing interventions can further standardize the usage of physical restraint,and effectively reduce the rates of using physical restraint and incorrect practice of physical restraint among patients in ICUs without increasing the risk of unplanned extubation.

Key words: Evidence-Based Nursing, Intensive Care Units, Restraint, Physical