ICU患者身体约束现状及问题分析

doi:10.3761/j.issn.1672-9234.2019.07.017

中华护理教育 ›› 2019, Vol. 16 ›› Issue (7): 544-546.doi: 10.3761/j.issn.1672-9234.2019.07.017

ICU患者身体约束现状及问题分析

王海妍¹,周芬¹,郭红¹,申艳玲²,柳清霞²,杨倮,赵菁²()

^1. 100029 北京市北京中医药大学护理学院（王海妍，周芬，郭红，杨倮）
^2. 中日友好医院（申艳玲,柳清霞,赵菁）

收稿日期:2018-12-03 出版日期:2019-07-20 发布日期:2019-08-08
作者简介:王海妍：女,本科（硕士在读）,护师,E-mail：1659488818@qq.com

Physical restraint of ICU patients and its problems

Hai-yan WANG¹,Fen ZHOU¹,Hong GUO¹,Yan-ling SHEN²,Qing-xia LIU²,Luo YANG,Jing ZHAO²()

Received:2018-12-03 Online:2019-07-20 Published:2019-08-08

摘要/Abstract

摘要： 目的了解目前临床ICU患者身体约束及护理现状,并分析存在的问题。方法通过查阅病例及身体约束相关护理文件获得患者资料,观察目前临床针对患者身体约束的评判依据、采取的约束方法、约束时间等,并参考临床实践指南相关指标,分析其差距及存在的问题。结果共纳入231例患者,其中64例患者使用身体约束,约束使用率为27.7%,约束总时长为7 906 h,平均约束时长为123.5 h,约束工具全部为约束带。在身体约束护理方面,医嘱与执行不相符合率为18.0%,护士在使用身体约束前均未使用评估工具进行评估。结论 ICU患者身体约束存在约束方法欠规范,缺乏适时有效的评估等问题,还需进一步规范约束方法,正确评估约束适用对象,提高约束效果,进而改善患者健康结局。

关键词: 重症监护病房, 约束, 身体的, 住院病人, 现状

Abstract: Objective To understand the physical restraint of ICU patients and to analyze the existing problems. Methods The data were obtained by checking the related nursing documents of physical restraint. Basis of patients' physical restraints,restraint methods,and duration of restraint were observed. The differences between the current practice and clinical guideline were compared. Results A total of 231 nursing documents were recruited and 64（27.7%） patients used physical restraint. The total duration of restraint was 7 906 hours with an average of 123.53 hours,the accuracy rate of the medical order and the implementation was 18%,and the nurse did not use the evaluation tool before the physical restraint. Conclusion There is a great gap between the present situation of physical restraint and clinical practice guidelines in ICU patients. It is necessary to standardize the restraint methods,assess the applicable patients,improve the restraint effects,and improve the health outcome of patients.

Key words: Intensive Care Units, Restraint, Physical, Inpatients, Status

王海妍,周芬,郭红,申艳玲,柳清霞,杨倮,赵菁. ICU患者身体约束现状及问题分析[J]. 中华护理教育, 2019, 16(7): 544-546.

Hai-yan WANG,Fen ZHOU,Hong GUO,Yan-ling SHEN,Qing-xia LIU,Luo YANG,Jing ZHAO. Physical restraint of ICU patients and its problems[J]. Chinese Journal of Nursing Education, 2019, 16(7): 544-546.

图/表 1

参考文献 12

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项目	类别	例数	百分比（%）
约束时间（h）	<25	25	39.06
	25~	10	15.62
	49~	4	6.25
	73~	5	7.81
	97~	7	10.94
	241~	6	9.38
	≥361	7	10.94
约束部位	双上肢	60	93.74
	一侧上肢	2	3.13
	四肢	2	3.13
约束替代方法	使用	5	7.81
	未使用	59	92.19
约束工具	约束带	64	100

ICU患者身体约束现状及问题分析

Physical restraint of ICU patients and its problems

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