Abstract:

Objective To construct a restraint grading program based on evaluation of delirium in ICU patients and to explore the effects of application. Methods Convenience sampling method was used to recruit 416 ICU patients in our hospital. Patients were divided into two groups：the experimental group with 214 cases receiving restraint grading program,and the control group with 202 cases using Restraint Decision Wheel developed in Canada in 2006. The restraint grading program was developed by three rounds of Delphi consultation. Results There were significant differences in total length of restraint time,restraint time of three levels,and disease outcomes（P<0.05） between two groups. Meanwhile,no significant differences were identified in patient satisfaction,rate of unplanned extubation,and falling bed （P>0.05） between two groups. Conclusion The restraint grading program can reduce the restraint time,the rate and severity of restraint,improve the disease outcomes,and guarantee patients’ safety.

Key words: Intensive Care Units, Delirium, Restraint, Physical, Nursing Assessment, Patient-Centered Care

摘要：

目的 构建ICU患者谵妄评估约束分级方案并探讨其临床应用效果。 方法 运用德尔菲专家函询法构建ICU患者谵妄评估约束分级方案。采用方便抽样法,选择416例ICU住院患者为研究对象,按护理单元将其分为试验组214例、对照组202例。试验组采用ICU患者谵妄评估约束分级方案进行谵妄评估及约束;对照组采用加拿大ICU约束决策轮及等级工具进行约束指导。 结果 比较两组总约束时间、各级约束时间、疾病转归等,差异具有统计学意义（P<0.05）。在患者满意度、非计划性拔管率、坠床/跌倒方面,差异无统计学意义（P >0.05）。 结论 基于德尔菲专家函询法构建的ICU患者谵妄评估约束分级方案,可减少ICU患者的约束时间,降低患者身体约束率及约束强度,改善患者的预后,保障了患者的安全。

关键词: 重症监护病房, 谵妄, 约束, 身体的, 护理评估, 以病人为中心医护