三甲医院ICU护士对患者实施身体约束护理现状调查

目的了解三甲医院ICU护士对患者实施身体约束护理的现状,为患者身体约束规范干预提供参考。方法自设观察记录表,对乌鲁木齐3所三甲医院160名ICU护士日间8h身体约束实践进行直接观察并记录。结果ICU护士实施身体约束的主要对象是气管插管(41.25%)及躁动患者(20.00%),常用的约束用具为约束带(89.38%)、乒乓球约束手套(12.50%)等。身体约束致非计划拔管、肢体末端水肿、约束部位皮下淤斑、骶尾部压疮加重发生率为2.50%~8.75%;护士对患者身体约束护理过程中存在推、拽、拉、吼等状况。结论ICU护理人员对患者实施身体约束护理质量亟待改善,护理管理者应针对暴露的问题做出系统方面与机制方面的改进,切实维护患者利益。

Physical restraint practice of ICU nurses in tertiary hospitals:an observational study

Objective To describe the status of physical restraint practice of ICU nurses in tertiary hospitals,and to provide reference for standardizing restraint use.Methods A total of 160 ICU nurses were selected from 3 tertiary hospitals in Urumqi and their physical restraint practice during 8-h day shift were observed and recorded using a self-designed observation sheet.Results Patients with endotracheal intubation and those who are agitated were the main targets of restraint use,accounting for 41.25 ％ and 20.00 ％ respectively.The most commonly used restraint device was restraint strap (89.38％),followed by gloves (12.50％),etc.Physical restraint induced complications/adverse events included unplanned extubation,distal extremity swelling,subcutaneous ecchy mosis at restraint sites,and sacrococcygeal pressure ulcer,with the incidence being 2.50 ％-8.75 ％.Nurses pushed,pulled and yelled to patients during physical restraint practice.Conclusion Physical restraint practice of ICU nurses should be improved,and nursing managers need to take measures targeted to the identified problems,thus to protect patients from harm.