目的 探讨基于米勒金字塔模型设计的针对神经外科监护室（neurosurgical intensive care unit，NICU）护士的身体约束培训计划应用效果。方法 根据现场观察与提问、半结构化访谈结果，设计基于米勒金字塔模型的针对NICU护士的身体约束培训计划。采用便利抽样法，将某三级甲等医院NICU护士根据其实际分管床位情况分为试验组和对照组，每组19名，对照组接受常规身体约束培训，试验组接受基于米勒金字塔模型设计的身体约束培训。便利选取2024年1月—3月各组分管的139例患者作为观察对象。比较两组对身体约束的使用正确率，以及护理的患者身体约束率、非计划性拔管率和皮肤受损发生率。结果 试验组对身体约束的使用正确率高于对照组，护理的患者身体约束率低于对照组（P<0.05）。两组护理的患者非计划性拔管率和皮肤受损发生率比较，差异无统计学意义（P>0.05）。结论 基于米勒金字塔模型设计的身体约束培训能在不增加患者不良事件发生率的情况下提高NICU护士对身体约束的使用正确率，降低NICU患者身体约束率，适合推广。

Objective To explore the application effects of a physical restraint training program for nurses in neurosurgical intensive care unit（NICU） based on Miller's Pyramid design. Methods A physical restraint training program for NICU nurses was designed based on Miller's Pyramid，which incorporating findings from on-site observations，questioning，and semi-structured interviews. Nurses working in the NICU of a tertiary hospital were divided into an experimental or a control group（19 nurses each） based on their actual patient assignments. The control group received routine physical restraint training，while the experimental group underwent physical restraint training designed based on Miller's Pyramid. A total of 139 patients managed by each group from January to March 2024 were selected as observation participants through convenience sampling. The correct application rate of physical restraints，along with the incidence rates of physical restraint use，unplanned extubation，and skin injuries among patients cared for by both groups，were collected and compared. Results The experimental group demonstrated a higher correct application rate of physical restraints and lower physical restraint application rates compared to the control group（P<0.05）. Besides，no statistically significant differences were observed in the incidence rates of unplanned extubation and skin injuries between the two groups（P>0.05）. Conclusion Physical restraint training based on Miller's Pyramid can improve the correct application rate of restraints by NICU nurses and reduce physical restraint usage in patients without increasing adverse event rates，making it suitable for further implementation.