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。

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.