Abstract:

Objective To investigate the prevalence of physical restraint in neuro-ICU patients and to analyze the risk factors.Methods A total of 337 neuro-ICU patients from four tertiary hospitals in Beijing were selected by means of convenience sampling. Data were collected using a self-designed questionnaire of Physical Restraints Use in Neuro-ICU Patients.Results The prevalence of patients with body restraint was 62.3%. 43.8% of the nurses performed physical constraint based on experience. Body-constrained parts was documented in 29.5% of the nursing records,and 50.5% recorded the start and release time. Evaluation during restraint was documented in 60% records. The influencing factors of physical restraint use were decision makers,indwelling nasogastric tube,state of consciousness,risk of pressure ulcers,type of invasive devices,and delirium.Conclusion The rate of body restraint in neurology ICU patients was at a high level and body restraint was not standardized. The indications for the use and release of physical restraint need to be clarified. Influencing factors can provide a basis for clinical nurses and nursing managers to design physical restraint strategy for patients in neurology ICU.

Key words: Physical Restraints, Neurology, Intensive Care Unit, Root Case Analysis

摘要：

目的 调查神经内科ICU患者身体约束使用现状并分析其影响因素。方法 采用方便抽样的方法,抽取北京地区4所三级甲等综合医院神经内科ICU患者337例作为研究对象,通过神经内科ICU患者身体约束现状调查表收集资料并分析。结果 患者身体约束率为62.3%;43.8%的护士是依据经验决策患者身体约束;29.5%实施身体约束患者的约束部位被记录了,50.5%实施身体约束患者的约束开始和解除时间被记录了,患者约束过程中有评估记录占60.0%。身体约束的独立影响因素包括约束决策人、留置鼻胃管、意识状态、压力性损伤风险、侵入性管路种类和谵妄等6个变量。结论 神经内科ICU患者身体约束率处于较高水平且缺少相关制度和规范,身体约束使用和解除的指征有待明确,身体约束决策人、留置鼻胃管、意识状态、压力性损伤风险、侵入性管路种类和谵妄为神经内科ICU患者身体约束的影响因素。

关键词: 身体约束, 神经内科, 重症病房, 影响因素分析